Seneviratne Deepthi R, Stavrou Panagiota, Good Peter
Birmingham and Midland Eye Centre, City Hospital, Birmingham, United Kingdom.
Optometry. 2011 Apr;82(4):215-7. doi: 10.1016/j.optm.2010.09.014.
Metastatic tumors to the choroid represent the most common uveal malignancy in adults. The most common origin of choroidal metastasis is from the breast and lung. Choroidal metastasis from thyroid carcinoma is rare. We report a case of choroidal metastasis that presented 36 years after the patient was initially diagnosed with follicular thyroid carcinoma.
A 74-year-old Afro-Caribbean woman with nonproliferative diabetic retinopathy presented to the diabetic clinic for a routine 6-month review. A dilated fundus examination found bilateral background diabetic retinopathy and a large metastatic lesion in the periphery of the right eye. Ocular ultrasonography was performed. The patient had undergone partial thyroidectomy for nodular goiter in 1969. Biopsy of skeletal metastases in 1982 confirmed that the primary was follicular thyroid carcinoma. She died 9 months after presentation with choroidal metastasis from progressive metastatic disease.
Choroidal metastasis may appear in the late stage of a very long period of known thyroid metastatic disease. It can develop fairly rapidly without causing any ocular symptoms.
脉络膜转移瘤是成人最常见的葡萄膜恶性肿瘤。脉络膜转移最常见的原发部位是乳腺和肺。甲状腺癌转移至脉络膜较为罕见。我们报告一例脉络膜转移瘤病例，该患者最初被诊断为滤泡性甲状腺癌36年后出现脉络膜转移。
一名74岁患有非增殖性糖尿病视网膜病变的非洲加勒比裔女性到糖尿病诊所进行常规的6个月复查。散瞳眼底检查发现双侧背景性糖尿病视网膜病变以及右眼周边有一个大的转移病灶。进行了眼部超声检查。该患者于1969年因结节性甲状腺肿接受了甲状腺部分切除术。1982年骨骼转移灶活检证实原发灶为滤泡性甲状腺癌。她在出现脉络膜转移9个月后因进行性转移性疾病死亡。
脉络膜转移可能出现在已知甲状腺转移性疾病很长时间的晚期。它可能发展相当迅速且不引起任何眼部症状。
