Binkley Elaine M, Sampson Aron D, Syed Nasreen A, Boldt H Culver
Department of Ophthalmology and Visual Science, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Ocul Oncol Pathol. 2020 Dec;6(6):405-409. doi: 10.1159/000510288. Epub 2020 Oct 16.
We describe a case of a 53-year-old man with a history of metastatic squamous cell carcinoma of the tonsil who presented with a large, dome-shaped, choroidal mass in the left eye with concern for extra-ocular extension. Standardized echography showed a choroidal mass with low-to-medium internal reflectivity, pockets of very low reflectivity, positive angle kappa, and 1+ vascularity that were concerning for primary choroidal melanoma. Biopsy of the lesion was consistent with metastatic squamous cell carcinoma of the tonsil rather than melanoma. This is only the second reported case of metastatic squamous cell carcinoma to the choroid presenting with a large vascular tumor with echographic characteristics consistent with choroidal melanoma. The unique vascularity present in some cases of squamous cell carcinoma of the tonsil may explain the vascularity and large height of this patient's lesion. Tumor fine-needle aspiration biopsy can play an important role in patients with choroidal lesions in the setting of unusual primary tumors.
我们描述了一例53岁男性患者，有扁桃体转移性鳞状细胞癌病史，左眼出现一个大的、圆顶状脉络膜肿物，怀疑有眼外扩展。标准化超声检查显示脉络膜肿物内部反射率为低至中等，有极低反射率区域，kappa角为阳性，血管分级为1+，这些表现提示原发性脉络膜黑色素瘤。病变活检结果与扁桃体转移性鳞状细胞癌相符，而非黑色素瘤。这是第二例报道的转移性扁桃体鳞状细胞癌累及脉络膜，表现为具有与脉络膜黑色素瘤一致的超声特征的大血管性肿瘤。扁桃体鳞状细胞癌某些病例中存在的独特血管情况可能解释了该患者病变的血管性和较大高度。在原发性肿瘤不常见的情况下，肿瘤细针穿刺活检对脉络膜病变患者可发挥重要作用。
