Papillary Thyroid Carcinoma; Bilateral Choroidal Metastases with Extrascleral Extension

Here, we present the case of a patient with bilateral choroidal metastases with extraocular extension in one eye. Metastasis of papillary thyroid carcinoma to the uvea is extremely rare, with only 6 patients reported in the literature. A 62-year-old man with a prior history of papillary thyroid carc...

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Bibliographic Details
Published in:Korean journal of ophthalmology 2013, 27(3), , pp.215-218
Main Authors: Kiratli, Hayyam, Tarlan, Berçin, Söylemezoğlu, Figen
Format: Article
Language:English
Subjects:
Carcinoma - pathology
Carcinoma - therapy
Carcinoma, Papillary
Case Report
Choroid
Choroid - pathology
Choroid Neoplasms - secondary
Choroid Neoplasms - therapy
Humans
Hyperthermia, Induced
Lung Neoplasms - secondary
Male
Middle Aged
Neoplasm metastasis
Papillary carcinoma
Sclera - pathology
Thyroid Cancer, Papillary
Thyroid gland
Thyroid Neoplasms - pathology
Thyroid Neoplasms - therapy
Transpupillary thermotherapy
안과학
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Summary:Here, we present the case of a patient with bilateral choroidal metastases with extraocular extension in one eye. Metastasis of papillary thyroid carcinoma to the uvea is extremely rare, with only 6 patients reported in the literature. A 62-year-old man with a prior history of papillary thyroid carcinoma suffered the rapid loss of vision in his right eye. He had neovascular glaucoma, total retinal detachment, and a solitary choroidal mass. A month later, his left visual acuity also decreased because of a small macular choroidal mass. The right eye was enucleated and a nodular lesion over the sclera representing extraocular extension was observed. This tumor and the intraocular lesion were composed of papillary excrescences and cystic spaces and stained positively for thyroid transcription factor 1 and thyroglobulin, all confirming the diagnosis of metastatic papillary thyroid carcinoma. The tumor in the left eye was successfully treated with diode laser transpupillary thermotherapy. The patient expired within a month as a result of widespread pulmonary metastases. Papillary thyroid carcinoma may metastasize to the uvea bilaterally, cause rapid visual function loss, erode the sclera, and may extend outside the globe similar to choroidal melanoma. This aggressive ocular involvement was associated with a dismal prognosis in our patient.
ISSN:1011-8942
2092-9382
2092-9382
DOI:10.3341/kjo.2013.27.3.215