Tumor-associated retinal pigment epithelial proliferation simulating retinal pigment epithelial tear.
A lesion with both the clinical and fluorescein angiographic appearance of the classical retinal pigment epithelial (RPE) tear was discovered over the dome of an actively growing metastatic choroidal tumor in a patient with a previous history of breast carcinoma. However, our patient exhibited no evidence of pigment epithelial detachment or age-related macular degeneration, the underlying cause of the RPE tear. Although we cannot be sure that a true RPE tear did not exist over our patient's tumor, more likely, we are observing a tumor induced zone of RPE dehiscence accompanied by RPE proliferation at its border, giving a very similar fundus appearance. Possible pathogenic mechanisms for the finding in our patient, and a comparison to those mechanisms responsible for the classical RPE tear, are discussed.
Leff
S R
SR
Retina-Vitreous Center, East Brunswick, NJ 08816.
Yarian
D L
DL
Shields
J A
JA
Masciulli
L
L
Green
S N
SN
D001859:Bone Neoplasms / Q000532:radiotherapy / Q000556:secondary; D001943:Breast Neoplasms / Q000150:complications / Q000532:radiotherapy; D002277:Carcinoma / Q000473:pathology* / Q000532:radiotherapy / Q000556:secondary; D002830:Choroid Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000556:secondary; D003937:Diagnosis, Differential; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000473:pathology*; D012167:Retinal Perforations / Q000473:pathology*; D014792:Visual Acuity