A Choroidal Oat-Cell Carcinoma Metastasis Mimicking a Choroidal Melanoma

Abstract

One and a half years ago, a thirty-eight-year old male patient was referred to us because of a prominent process in the upper temporal fundus quadrant of his right eye. The patient had complained of blurred vision and meta-morphopsia for two weeks. The patient was in good general condition. Ocular examination revealed a visual acuity of 25/200 in the right eye and 20/20 in the left eye. The left eye showed no abnormalities. Slitlamp examination of the right eye showed pigment-cells in the vitreous. Applanation pressure was normal. Ophthalmoscopy of the right eye revealed a very prominent yellow-gray lesion with a small haemorrhage on its surface. Below the lesion the retina was partly detached. Visual field examination showed an aboslute scotoma in the area of the lesion and fluorescein angiography showed a picture most consistent with a choroidal melanoma. Echographic A mode examination with the Kretztechnik 7200 MA (Ossoinig 1974) revealed a mass lesion with a smooth surface and maximal prominence of 7 mm of solid consistancy, low to medium reflectivity with spontaneous movements (vascularity), B-scanning with the Bronson-Turner unit showed a spherical shaped lesion with choroidal excavation and retinal detachment at its base. (Fig. 1a, b)