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Hürthle cell carcinoma metastatic to the uvea
1Oculoplastic, Orbital, and Ophthalmic Oncology Service, Duke University Eye Center, Durham, North Carolina 27707.
Background:
The authors present a case of Hürthle cell carcinoma metastatic to the uvea in a patient with known Hürthle cell tumor of the thyroid. The fluorescein angiogram suggested a neoplastic lesion, and the collar-button configuration resembled a malignant melanoma. However, standardized echography revealed high internal reflectivity and an irregular acoustic structure suggestive of a metastatic carcinoma.
Methods:
The clinical history and examination were consistent with the diagnosis of metastatic Hürthle cell carcinoma of the eye. Results of a fine-needle aspiration biopsy and histopathology of the intraocular lesion confirmed the diagnosis.
Results:
Because this was the patient's better-seeing eye, the tumor was treated with an 125I radioactive episcleral plaque. Over the subsequent 27 months, the lesion demonstrated a gradual regression.
Conclusions:
We have not found any previously reported cases of Hürthle cell carcinoma of the thyroid metastatic to the eye. The diagnosis may be confirmed safely by intraocular aspiration biopsy. The lesion is responsive to radioactive plaque application. The origin, pathology, and management of this unusual tumor are reviewed.