title: A choroidal amyloid-rich neuroendocrine tumor: initial manifestation of Cushing syndrome.
abstract: A 57-year-old man with a history of hepatic adenocarcinoma was referred 3 years after his diagnosis with a choroidal tumor in the right eye. Results of a transscleral excision biopsy revealed the tumor to be an amyloid-rich neuroendocrine metastasis. The patient subsequently developed cushingoid features and investigations revealed ectopic corticotropin syndrome, an elevated urinary 5-hydroxyindoleacetic acid level, and neuroendocrine metastasis in several locations. The choroidal neuroendocrine metastasis stained negative for serotonin and corticotropin. The source of the ectopic corticotropin and the location of the primary tumor have not been found. This case demonstrates that disseminated neuroendocrine tumors may rarely cause ocular lesions before systemic endocrine sequelae arise.
authors.affiliation: Royal Liverpool University Hospital, St Paul's Eye Unit, England.
authors.forename: S O
authors.initials: SO
authors.lastname: Brannan
authors.forename: N G
authors.initials: NG
authors.lastname: Lessan
authors.forename: P
authors.initials: P
authors.lastname: Hiscott
authors.forename: B
authors.initials: B
authors.lastname: Damato
mesh_terms: D000686:Amyloidosis / Q000473:pathology* / Q000601:surgery / Q000652:urine; D002830:Choroid Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery / Q000652:urine; D003480:Cushing Syndrome / Q000175:diagnosis* / Q000652:urine; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000652:urine; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery / Q000652:urine
chemical_list: D006897:Hydroxyindoleacetic Acid