International Journal of Ophthalmic PathologyISSN: 2324-8599

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Letter to Editor, Int J Ophthalmic Pathol Vol: 4 Issue: 3

Letter to Editor : A Case of Choroidal Metastasis Determined to be Hepatocellular Carcinoma

Neepa Shah1*, Vivian Le1,2, Franz Fogt2, Joan M O’Brien1
1Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania Health System, Philadelphia, PA
2Department of Pathology and Laboratory Medicine, Penn Presbyterian Medical Center, University of Pennsylvania Health System, Philadelphia, PA
Corresponding author : Neepa Shah
Scheie Eye Institute, Presbyterian Medical Center 51 N 39th St. Philadelphia PA 19104, USA
Tel: 215-662-8100
E-mail: [email protected]
Received: August 11, 2015 Accepted: August 29, 2015 Published: September 03, 2015
Citation: Shah N (2015) Letter to Editor : A Case of Choroidal Metastasis Determined to be Hepatocellular Carcinoma. J Ophthalmic Pathol 4:3. doi:10.4172/2324-8599.1000163

Abstract

This letter is in response to the case published last month in your journal: “A Case of Choroidal Metastasis Determined to be Hepatocellular Carcinoma” for which I was the primary author. As it was noted in this publication, hepatocellular carcinoma (HCC).

Keywords: Hepatocellular carcinoma

Letter to Editor

This letter is in response to the case published last month in your journal: “A Case of Choroidal Metastasis Determined to be Hepatocellular Carcinoma” for which I was the primary author. As it was noted in this publication, hepatocellular carcinoma (HCC) metastasis to the eye is a very uncommonly seen. Only a handful of cases have been reported in the literature of HCC metastatic to the eye [1-6]. Our case with the first case described of a patient without a known primary malignancy to present with choroidal metastasis later determined to be HCC. A couple months ago, our patient unfortunately passed away from his systemic malignancy and his family consented to autopsy of his globe for research purposes. We were able to enucleate and process the specimen of his right eye and found the posterior choroidal lesion to indeed represent hepatocellular carcinoma metastasis (Figure 1). Thus, pathology does confirm our case to be the first in the literature of hepatocellular carcinoma presenting initially as choroidal metastasis. It also conveys a poor systemic prognosis as the total time between identification of this lesion and ultimate death of the patient was 6 months.
Figure 1: (A) Gross photograph of right globe with arrow pointing to posterior choroidal lesion (B) Photomicrograph of posterior choroidal lesion (hematoxylin and eosin, 10X) (C) Photomicrograph of choroidal lesion demonstrating infiltration by atypical hepatocytes (hematoxylin and eosin, 40X) (D)Photomicrograph of choroidal lesion demonstrating HPC immunohistochemistry positivity, confirming hepatic lineage of infiltrate (HPC IHC, 40X).

References

  1. Taake WH, Allen RA, Straatsma BR (1963) Metastasis of a Hepatoma to the Choroid. Am J Ophthalmol 56: 208-213.

  2. Yeatts RP, Campbell RJ, Lie JT (1982) Hepatocellularcarcinomametastatic to the choroid. ArchPatholLab Med 106: 256-257.

  3. MalaviyaL ,Shields CL, Turaka K, Ehya H, Shields JA (2011) Choroidalmetastasisfromhepatocellularcarcinoma, diagnosed by fine needle aspiration biopsy and treated by iodine-125 brachytherapy. GraefesArch Clin ExpOphthalmol 249: 1095-1098.

  4. Tateno H, Hoshino T, Takahashi K, Matsumura M, Sakaida N, et al.(2009) A rapidlyprogressedmetastaticchoroidal tumor from a hepatocellularcaricinoma. Nihon GankaGakkaiZassh 113:107-11.

  5. WesolowskiR , Chung JY, Singh A, Kim R (2010) Hepatocellularcarcinomametastatic to uvea. Retin Cases BriefRep 4: 178-180.

  6. Shah N, Bhojwani N, Au A, Lee V, Fogt F, et al. (2015) A Case of ChoroidalMetastasisDetermined to beHepatocellularCarcinoma . J Ophthalmic Pathol 4:2.

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