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Metastatic Small-Cell Neuroendocrine Carcinoma Simulating Circumscribed Choroidal Hemangioma
Kate E Leahy1, Tanya Karaconji2, Valli Thanni3
1Department of Ophthalmology, Institute for Clinical Pathology and Medical Research, Westmead Hospital, N.S.W., Australia.
Aim:
To report a case of metastatic small-cell neuroendocrine carcinoma presenting as an isolated choroidal mass and initially misdiagnosed as a circumscribed choroidal hemangioma.
Methods:
The clinical history, fundus findings, imaging, cytology and immunohistochemical features are described.
Results:
An otherwise healthy 66-year-old man was referred for a left nasal scotoma and a diagnosis of circumscribed choroidal hemangioma. Cytology showed cohesive clusters of small-to-intermediate malignant cells. The atypical cells stained positively for chromogranin, thyroid transcription factor-1 and synaptophysin consistent with small-cell neuroendocrine carcinoma.
Conclusion:
Small-cell neuroendocrine carcinoma metastatic to the choroid is extremely rare; however, it is particularly aggressive and should be included in the differential diagnosis of isolated choroidal lesions, even in otherwise healthy patients.
