Diagnostic surprise in an evisceration specimen. 2007

Muhammad Usman Saeed, and Bernard Yp Chang, and Seema Anand, and Arundhati Chakrabarty
Department of Ophthalmology, Clarendon Wing, Leeds General Infirmary, Leeds, UK. musmansaeed@aol.com

OBJECTIVE To report a rare ocular tumor discovered incidentally after evisceration of a painful blind eye. METHODS Observational case report. RESULTS A 67-year-old Caucasian lady presented for elective evisceration of chronically irritable phthisical right eye. A history of bilateral retinal detachment surgery 34 years prior followed by phthisis of the right eye was noted. The patient was a smoker but otherwise fit and well. Intra-operatively, the ocular contents were felt to be unusual with hard deeply pigmented lumps being present in the eviscerated tissue. The specimen was sent for histopathology. This was reported as a primary adenocarcinoma of the retinal pigment epithelium after expert histological opinion. The possibilities of a secondary adenocarcinoma with possible primary sites as lung, breast or kidney were ruled out by immuno-histochemical techniques. The patient underwent extensive systemic screening including a whole body CT scan. Exhaustive investigations have not found any other tumor site. CONCLUSIONS In the absence of a recognizable source of metastasis, a diagnosis of primary ocular adenocarcinoma has been made with retinal pigment epithelium being the possible site of origin. Literature review shows that primary ocular adenocarcinoma arising from neuroepithelium is a rare but recognized occurrence especially in longstanding blind eyes. This case highlights the importance of routine histopathological examination of eviscerated ocular contents, especially in long standing blind eyes.

UI MeSH Term Description Entries
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000230 Adenocarcinoma A malignant epithelial tumor with a glandular organization. Adenocarcinoma, Basal Cell,Adenocarcinoma, Granular Cell,Adenocarcinoma, Oxyphilic,Adenocarcinoma, Tubular,Adenoma, Malignant,Carcinoma, Cribriform,Carcinoma, Granular Cell,Carcinoma, Tubular,Adenocarcinomas,Adenocarcinomas, Basal Cell,Adenocarcinomas, Granular Cell,Adenocarcinomas, Oxyphilic,Adenocarcinomas, Tubular,Adenomas, Malignant,Basal Cell Adenocarcinoma,Basal Cell Adenocarcinomas,Carcinomas, Cribriform,Carcinomas, Granular Cell,Carcinomas, Tubular,Cribriform Carcinoma,Cribriform Carcinomas,Granular Cell Adenocarcinoma,Granular Cell Adenocarcinomas,Granular Cell Carcinoma,Granular Cell Carcinomas,Malignant Adenoma,Malignant Adenomas,Oxyphilic Adenocarcinoma,Oxyphilic Adenocarcinomas,Tubular Adenocarcinoma,Tubular Adenocarcinomas,Tubular Carcinoma,Tubular Carcinomas
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D017234 Eye Evisceration The surgical removal of the inner contents of the eye, leaving the sclera intact. It should be differentiated from ORBIT EVISCERATION which removes the entire contents of the orbit, including eyeball, blood vessels, muscles, fat, nerve supply, and periosteum. Evisceration, Eye,Eviscerations, Eye,Eye Eviscerations
D019572 Retinal Neoplasms Tumors or cancer of the RETINA. Cancer of the Retina,Cancer, Retinal,Neoplasms, Retinal,Retinal Cancer,Retinal Tumors,Tumors, Retinal,Cancers, Retinal,Neoplasm, Retinal,Retinal Cancers,Retinal Neoplasm,Retinal Tumor,Tumor, Retinal
D033162 Incidental Findings Unanticipated information discovered in the course of testing or medical care. Used in discussions of information that may have social or psychological consequences, such as when it is learned that a child's biological father is someone other than the putative father, or that a person tested for one disease or disorder has, or is at risk for, something else. Incidental Discovery,Discoveries, Incidental,Discovery, Incidental,Finding, Incidental,Findings, Incidental,Incidental Discoveries,Incidental Finding

Related Publications

Muhammad Usman Saeed, and Bernard Yp Chang, and Seema Anand, and Arundhati Chakrabarty
April 2008, Southern medical journal,
Muhammad Usman Saeed, and Bernard Yp Chang, and Seema Anand, and Arundhati Chakrabarty
March 2021, Iranian journal of otorhinolaryngology,
Muhammad Usman Saeed, and Bernard Yp Chang, and Seema Anand, and Arundhati Chakrabarty
April 2024, International journal of surgical pathology,
Muhammad Usman Saeed, and Bernard Yp Chang, and Seema Anand, and Arundhati Chakrabarty
July 2020, BMJ open quality,
Muhammad Usman Saeed, and Bernard Yp Chang, and Seema Anand, and Arundhati Chakrabarty
January 1864, The Chicago medical journal,
Muhammad Usman Saeed, and Bernard Yp Chang, and Seema Anand, and Arundhati Chakrabarty
July 2009, International journal of STD & AIDS,
Muhammad Usman Saeed, and Bernard Yp Chang, and Seema Anand, and Arundhati Chakrabarty
May 1879, Atlanta medical and surgical journal,
Muhammad Usman Saeed, and Bernard Yp Chang, and Seema Anand, and Arundhati Chakrabarty
October 1988, Radiography today,
Muhammad Usman Saeed, and Bernard Yp Chang, and Seema Anand, and Arundhati Chakrabarty
July 2004, JEMS : a journal of emergency medical services,
Muhammad Usman Saeed, and Bernard Yp Chang, and Seema Anand, and Arundhati Chakrabarty
January 1990, Recenti progressi in medicina,
Copied contents to your clipboard!