Cancer-associated retinopathy in neuroendocrine carcinoma of the fallopian tube

Abstract

A 70-year-old woman developed progressive visual loss with compromised visual acuity and visual fields, cells in the anterior chamber and vitreous, attenuated retinal arterioles, and macular edema. She had undergone right oophorectomy and partial salpingectomy nearly 50 years earlier. Full-field and multifocal electroretinography showed waveforms of markedly attenuated amplitudes, findings consistent with cancer-associated retinopathy (CAR). Positron emission tomography revealed a nodule in the anterior wall of a right hydrosalpinx. Total laparoscopic hysterectomy yielded a neuroendocrine fallopian tube malignancy. She underwent partial treatment with paclitaxel and carboplatin that was aborted because of the development of herpes zoster infection. At 15 months following diagnosis, her ophthalmic status was stable. This is the first report of CAR in neuroendocrine carcinoma of the fallopian tube.

FIG. 1

Full-field electroretinography performed 2 months before our first consultation shows attenuated or extinguished responses in photopic single flash (A), photopic 30 Hz flicker (B), scotopic potential (C), photopic and scotopic potentials (D), and oscillatory potential (E).

FIG. 2

Visual fields show bilateral ring-like scotomas with small areas of central preservation. Mean deviations were −21.5 dB in the left eye and −21.32 dB in the right eye.

FIG. 3

Histopathology of the surgical specimen of the fallopian tube. A. Low-power view of tumor shows extensive necrosis (hematoxylin and eosin ×100). B. High-power view shows cells with hyperchromatic irregularly shaped nuclei and scant indistinct cytoplasm, numerous mitotic figures, and great variation in tumor cell size (hematoxylin and eosin ×400). C. Immunohistochemical staining of neoplastic cells is positive for epithelial membrane antigen. In addition, these neoplastic cells are also positive for cytokeratin, synaptophysin, and neurofilament and negative for leukocyte common antigen (not shown).