Metastatic Squamous Cell Carcinoma of the Tonsil Mimicking Choroidal Melanoma

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 refl...

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Bibliographic Details
Published in:Ocular oncology and pathology 2020-12, Vol.6 (6), p.405-409
Main Authors: Binkley, Elaine M., Sampson, Aron D., Syed, Nasreen A., Boldt, H. Culver
Format: Article
Language:English
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Novel Insights from Clinical Practice
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Summary: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.
ISSN:2296-4681
2296-4657
DOI:10.1159/000510288