title: Choroidal metastases from thymic carcinoma during pregnancy: Case Report.
abstract: BACKGROUND
  Rare sites of metastases, atypical symptoms and paraneoplastic syndromes are often neglected or misinterpreted, especially when they represent early symptoms of an underlying malignant disease. Hence, an interdisciplinary approach to these patients is essential to avoid tumor progression and metastatic spread in order to provide curative treatment options to the patients. We here report the case of a young woman presenting with visual loss which led to diagnosis of a thymic carcinoma.
  
  
  METHODS
  A 28-year old white woman presented with subacute loss of vision in the last trimester of her first pregnancy which was first interpreted as an exacerbation of a pre-existing dermatomyositis and treated with steroids. After failure of steroid therapy choroidal metastases from an undifferentiated thymic carcinoma were diagnosed. This also shed a new light on the dermatomyositis the patient had been suffering from for seven years possibly representing a paraneoplastic syndrome from the tumor. Despite aggressive chemotherapy, the patient died from progressive disease eight years after first onset of dermatomyositis and 14 months after initial diagnosis of the thymic carcinoma.
  
  
  CONCLUSIONS
  Choroidal metastases from a thymic carcinoma have never been reported before but should be included into the differential diagnosis of choroidal masses.
authors.affiliation: Medizinische Universitaetsklinik Tuebingen, Innere Medizin II fuer Onkologie, Haematologie, Immunologie, Rheumatologie und Pulmologie, Otfried Mueller Str. 10, D-72076, Tuebingen, Germany. sebastian.haen@med.uni-tuebingen.de.|Interfakultaeres Institut fuer Zellbiologie, Abteilung Immunologie, Auf der Morgenstelle 15, D-72076, Tuebingen, Germany. sebastian.haen@med.uni-tuebingen.de.
authors.forename: Sebastian P
authors.initials: SP
authors.lastname: Haen
authors.affiliation: Pathologisches Institut, Universitaetsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, D-68167, Mannheim, Germany. philipp.stroebel@med.uni-goettingen.de.|Institut fuer Pathologie, Universitaetsmedizin Goettingen, Robert-Koch-Str. 40, D-37075, Goettingen, Germany. philipp.stroebel@med.uni-goettingen.de.
authors.forename: Philipp
authors.initials: P
authors.lastname: Stroebel
authors.affiliation: Pathologisches Institut, Universitaetsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, D-68167, Mannheim, Germany. alexander.marx@umm.de.
authors.forename: Alexander
authors.initials: A
authors.lastname: Marx
authors.affiliation: Departement fuer Augenheilkunde, Universitaetsklinikum Tuebingen, Schleichstr. 12, D-72076, Tuebingen, Germany. daniela.suesskind@med.uni-tuebingen.de.
authors.forename: Daniela
authors.initials: D
authors.lastname: Suesskind
authors.affiliation: Institut fuer Pathologie, Abteilung fuer Allgemeine Pathologie und Pathologische Anatomie, Universitaetsklinikum Tuebingen, Liebermeisterstr. 8, D-72076, Tuebingen, Germany. falko.fend@med.uni-tuebingen.de.
authors.forename: Falko
authors.initials: F
authors.lastname: Fend
authors.affiliation: Radioonkologische Klinik, Universitaetsklinikum Tuebingen, Hoppe-Seyler-Str. 3, D-72076, Tuebingen, Germany. reichmann@strahlentherapie-fn.de.
authors.forename: Ursula
authors.initials: U
authors.lastname: Reichmann
authors.affiliation: Medizinische Universitaetsklinik Tuebingen, Innere Medizin II fuer Onkologie, Haematologie, Immunologie, Rheumatologie und Pulmologie, Otfried Mueller Str. 10, D-72076, Tuebingen, Germany. hans-georg.kopp@med.uni-tuebingen.de.
authors.forename: Hans-Georg
authors.initials: HG
authors.lastname: Kopp
authors.affiliation: Medizinische Universitaetsklinik Tuebingen, Innere Medizin II fuer Onkologie, Haematologie, Immunologie, Rheumatologie und Pulmologie, Otfried Mueller Str. 10, D-72076, Tuebingen, Germany. lothar.kanz@med.uni-tuebingen.de.
authors.forename: Lothar
authors.initials: L
authors.lastname: Kanz
authors.affiliation: Medizinische Universitaetsklinik Tuebingen, Innere Medizin II fuer Onkologie, Haematologie, Immunologie, Rheumatologie und Pulmologie, Otfried Mueller Str. 10, D-72076, Tuebingen, Germany. frank.mayer@med.uni-tuebingen.de.
authors.forename: Frank
authors.initials: F
authors.lastname: Mayer
mesh_terms: D000328:Adult; D002830:Choroid Neoplasms / Q000556:secondary*; D003882:Dermatomyositis / Q000209:etiology; D005260:Female; D006801:Humans; D010257:Paraneoplastic Syndromes / Q000209:etiology* / Q000473:pathology; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology*; D013945:Thymoma / Q000556:secondary*; D013953:Thymus Neoplasms / Q000473:pathology*; D014786:Vision Disorders / Q000209:etiology