Hui Michelle M, Merani Rohan, Bonar Fiona, Hong Angela M, Fung Adrian T
Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
Am J Ophthalmol Case Rep. 2019 Feb 22;14:55-57. doi: 10.1016/j.ajoc.2019.02.009. eCollection 2019 Jun.
To report a case of presumed choroidal metastasis from soft tissue myoepithelial carcinoma and highlight challenges in its diagnosis.
A 52-year-old man was referred with a two-week history of photopsia in his left eye. His background medical history included known soft tissue myoepithelial carcinoma metastatic to his bone, lung, liver and chest wall. A large, raised, yellow choroidal lesion was identified nasal to and abutting the optic disc. This lesion demonstrated growth 1 month after presentation. The patient died with widespread metastatic disease 5 months after initial presentation.
Soft tissue myoepithelial carcinoma can rarely metastasise to the choroid and present as a rapidly-growing, yellow, echodense tumour with serous retinal detachment. MRI brain can assist in tumour evaluation and monitoring progression, while immunoperoxidase stains and molecular testing can assist with diagnosis. The condition has an aggressive natural history and poor prognosis.
报告一例疑似软组织肌上皮癌脉络膜转移的病例,并强调其诊断中的挑战。
一名52岁男性因左眼有两周的闪光感病史前来就诊。他的既往病史包括已知软组织肌上皮癌已转移至骨骼、肺、肝脏和胸壁。在视盘鼻侧发现一个大的、隆起的黄色脉络膜病变,与视盘相邻。该病变在就诊后1个月出现生长。患者在初次就诊后5个月死于广泛转移疾病。
软组织肌上皮癌很少转移至脉络膜,表现为快速生长的黄色、回声致密的肿瘤伴浆液性视网膜脱离。头颅磁共振成像(MRI)有助于肿瘤评估和监测进展,而免疫过氧化物酶染色和分子检测有助于诊断。该病自然病程侵袭性强,预后差。