title: Metastatic adenocarcinoma with rupture through the Bruch membrane simulating a choroidal melanoma.
abstract: OBJECTIVE
  To report a case of adenocarcinoma metastatic to the choroid with rupture through the Bruch membrane, thus, simulating a choroidal melanoma.
  
  
  METHODS
  Interventional case report. Evaluation in a university-based clinic, including a complete eye examination, fluorescein angiography, and ultrasonography; oncological evaluation; and eventual enucleation with histopathological study, including immunohistochemical stains.
  
  
  RESULTS
  A 62-year-old Hispanic female presented with visual loss, right eye, of short duration because of a choroidal mass with retinal detachment. Ultrasonography showed a dome-shaped lesion with an eccentric collar-button projection and medium internal reflectivity, which suggested a choroidal melanoma. Initial systemic evaluation was negative. Severe pain necessitated enucleation, RE, and histopathology of the choroidal mass demonstrated an adenocarcinoma. Further examination revealed a left, upper lobe, nonsmall cell lung carcinoma.
  
  
  CONCLUSIONS
  Metastatic choroidal tumors may present, although rarely, with collar-button configurations.
authors.affiliation: Department of Ophthalmology, University of Alabama School of Medicine, 700 18th Street S, EFH 601, Birmingham, AL 35233, USA. rwr@uab.edu
authors.forename: R W
authors.initials: RW
authors.lastname: Read
authors.forename: R L
authors.initials: RL
authors.lastname: Green
authors.forename: N A
authors.initials: NA
authors.lastname: Rao
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D001932:Brain Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D016570:Bruch Membrane / Q000000981:diagnostic imaging / Q000473:pathology*; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000188:drug therapy; D002830:Choroid Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D003937:Diagnosis, Differential; D015353:Eye Enucleation; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007124:Immunoenzyme Techniques; D008175:Lung Neoplasms / Q000175:diagnosis / Q000188:drug therapy; D008545:Melanoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis; D012163:Retinal Detachment / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012422:Rupture, Spontaneous; D014463:Ultrasonography
chemical_list: D014408:Biomarkers, Tumor