title: Metastatic Small-Cell Neuroendocrine Carcinoma Simulating Circumscribed Choroidal Hemangioma.
abstract: OBJECTIVE
  To report a case of metastatic small-cell neuroendocrine carcinoma presenting as an isolated choroidal mass and initially misdiagnosed as a circumscribed choroidal hemangioma.
  
  
  METHODS
  The clinical history, fundus findings, imaging, cytology and immunohistochemical features are described.
  
  
  RESULTS
  An otherwise healthy 66-year-old man was referred for a left nasal scotoma and a diagnosis of circumscribed choroidal hemangioma. Cytology showed cohesive clusters of small-to-intermediate malignant cells. The atypical cells stained positively for chromogranin, thyroid transcription factor-1 and synaptophysin consistent with small-cell neuroendocrine carcinoma.
  
  
  CONCLUSIONS
  Small-cell neuroendocrine carcinoma metastatic to the choroid is extremely rare; however, it is particularly aggressive and should be included in the differential diagnosis of isolated choroidal lesions, even in otherwise healthy patients.
authors.affiliation: Department of Ophthalmology, Institute for Clinical Pathology and Medical Research, Westmead Hospital, N.S.W., Australia.
authors.forename: Kate E
authors.initials: KE
authors.lastname: Leahy
authors.affiliation: Department of Ophthalmology, Institute for Clinical Pathology and Medical Research, Westmead Hospital, N.S.W., Australia; Department of Sydney Eye Hospital, University of Sydney, N.S.W., Australia.
authors.forename: Tanya
authors.initials: T
authors.lastname: Karaconji
authors.affiliation: Department of Anatomical Pathology, Institute for Clinical Pathology and Medical Research, Westmead Hospital, N.S.W., Australia.
authors.forename: Valli
authors.initials: V
authors.lastname: Thanni
authors.affiliation: Department of Anatomical Pathology, Institute for Clinical Pathology and Medical Research, Westmead Hospital, N.S.W., Australia.
authors.forename: Anita
authors.initials: A
authors.lastname: Achan
authors.affiliation: Department of Anatomical Pathology, Institute for Clinical Pathology and Medical Research, Westmead Hospital, N.S.W., Australia; Department of Sydney Eye Hospital, University of Sydney, N.S.W., Australia; Department of Save Sight Institute, University of Sydney, N.S.W., Australia; Department of Australian School of Advanced Medicine, Macquarie University, Sydney, N.S.W., Australia.
authors.forename: Adrian T
authors.initials: AT
authors.lastname: Fung
keywords: Choroidal hemangioma; Choroidal metastasis; Immunohistochemistry; Metastasis; Neuroendocrine carcinoma; Small-cell carcinoma; Tumor