Carcinosarcoma choroidal metastasis
Contributor: Jesse Vislisel, MD
This patient presented with photopsias and was found to have an amelanotic, mildly elevated choroidal mass with irregular borders. OCT revealed an area of choroidal elevation with loculated areas of overlying subretinal fluid. The "lumpy-bumpy" appearance and loculated fluid collections are common with choroidal metastasis due to tumor involution in areas with insufficient blood supply. B-scan demonstrates a slightly lobulated area of mild choroidal elevation. In contrast to melanoma, choroidal metastases usually exhibit medium-high internal reflectivity on A-scan. This lesion had high internal reflectivity. Systemic workup was performed and revealed a previously undiagnosed uterine carcinosarcoma with systemic metastases. The primary tumor is undiagnosed at the time of presentation in approximately 1/3 of choroidal metastases.
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