Metastatic Small-Cell Neuroendocrine Carcinoma Simulating Circumscribed Choroidal Hemangioma

Abstract

<b><i>Aim:</i></b> To report a case of metastatic small-cell neuroendocrine carcinoma presenting as an isolated choroidal mass and initially misdiagnosed as a circumscribed choroidal hemangioma. <b><i>Methods:</i></b> The clinical history, fundus findings, imaging, cytology and immunohistochemical features are described. <b><i>Results:</i></b> 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. <b><i>Conclusion:</i></b> 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.

Choroidal metastasis resembling hemangioma on angiogram as initial manifestation of lung adenocarcinoma

“…Compared to FFA, the mottled hyper-fluorescence of the mass in the late phase is seldom described in ICGA. Even in a case report that misdiagnosed CM for hemangioma while presented ICGA result, ICGA still appeared hypo-fluorescent [10] . In circumscribed choroidal hemangioma, the angiogram is intense and achieves rapid hyper-fluorescence in both FFA and ICGA due to its rich intrinsic vasculature [11] .…”