Presumed choroidal metastasis from soft tissue myoepithelial carcinoma

Michelle M Hui¹, Rohan Merani^{2

3

4}, Fiona Bonar^{4

5

6}, Angela M Hong^{7

8}, Adrian T Fung^{3

4

9}

Affiliations

¹ Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
² Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
³ Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia.
⁴ Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
⁵ Douglass Hanly Moir Pathology, Macquarie Park, Sydney, New South Wales, Australia.
⁶ School of Medicine, Notre Dame University, Sydney, New South Wales, Australia.
⁷ Central Clinical School, University of Sydney, Sydney, New South Wales, Australia.
⁸ Genesis Cancer Care, Radiation Oncology, Mater Hospital, New South Wales, Australia.
⁹ Westmead Hospital, Sydney, New South Wales, Australia.

PMID: 30886937
PMCID: PMC6402231
DOI: 10.1016/j.ajoc.2019.02.009

Case Reports

Presumed choroidal metastasis from soft tissue myoepithelial carcinoma

Michelle M Hui et al. Am J Ophthalmol Case Rep. 2019.

. 2019 Feb 22:14:55-57.

doi: 10.1016/j.ajoc.2019.02.009. eCollection 2019 Jun.

Authors

Michelle M Hui¹, Rohan Merani^{2

3

4}, Fiona Bonar^{4

5

6}, Angela M Hong^{7

8}, Adrian T Fung^{3

4

9}

Affiliations

¹ Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
² Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
³ Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia.
⁴ Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
⁵ Douglass Hanly Moir Pathology, Macquarie Park, Sydney, New South Wales, Australia.
⁶ School of Medicine, Notre Dame University, Sydney, New South Wales, Australia.
⁷ Central Clinical School, University of Sydney, Sydney, New South Wales, Australia.
⁸ Genesis Cancer Care, Radiation Oncology, Mater Hospital, New South Wales, Australia.
⁹ Westmead Hospital, Sydney, New South Wales, Australia.

PMID: 30886937
PMCID: PMC6402231
DOI: 10.1016/j.ajoc.2019.02.009

Abstract

Purpose: To report a case of presumed choroidal metastasis from soft tissue myoepithelial carcinoma and highlight challenges in its diagnosis.

Observations: A 52-year-old man was referred with a two-week history of photopsia in his left eye. His background medical history included known soft tissue myoepithelial carcinoma metastatic to his bone, lung, liver and chest wall. A large, raised, yellow choroidal lesion was identified nasal to and abutting the optic disc. This lesion demonstrated growth 1 month after presentation. The patient died with widespread metastatic disease 5 months after initial presentation.

Conclusion and importance: Soft tissue myoepithelial carcinoma can rarely metastasise to the choroid and present as a rapidly-growing, yellow, echodense tumour with serous retinal detachment. MRI brain can assist in tumour evaluation and monitoring progression, while immunoperoxidase stains and molecular testing can assist with diagnosis. The condition has an aggressive natural history and poor prognosis.

Keywords: Choroid; Choroidal metastases; Myoepithelioma; Myoepithelioma carcinoma; Oncology; Soft tissue myoepithelioma.

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Figures

**Fig. 1**
A large raised yellow choroidal lesion is present nasal to and abutting the left optic disc (A). The lesion grew by 4mm (B) and 6mm (C) in diameter 2 and 4 weeks after presentation respectively. The lesion is isoautofluorescent but the areas of subretinal fluid are hyperautofluorescent (D). Optical coherence tomography demonstrates a small amount of subretinal fluid at the macula (E). B-scan ultrasonography shows an echodense tumour measuring 4.0mm in height with overlying and inferior subretinal fluid but no extraocular extension (F).

**Fig. 2**
Sheets and strands of tumour cells with epithelial morphology in a focally hyalinised stroma (A). Higher power shows highly atypical cells with vescicular nuclei, prominent nucleoli and several mitoses (arrow) (B). Cytokeratin 8/18 expression (C) and co-expression of S100 protein (D) supporting a myoepithelial tumour.

See this image and copyright information in PMC

References

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1. Waldrop C., Kathuria S.S., Toretsky J.A., Sun C.C. Myoepithelioma metastatic to the orbit. Am J Ophthalmol. 2001;132:594–596. - PubMed
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Presumed choroidal metastasis from soft tissue myoepithelial carcinoma

Affiliations

Presumed choroidal metastasis from soft tissue myoepithelial carcinoma

Authors

Affiliations

Abstract

Figures

References

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