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Uveal metastasis 43 years after resection of bronchogenic carcinoid
  1. E D E Kaiser,
  2. R F See,
  3. A K Rechdouni,
  4. Y Usui,
  5. J I Lim,
  6. N A Rao
  1. A Ray Irvine Ocular Pathology Laboratory, the Doheny Eye Institute, the Doheny Retina Institute, and the Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
  1. Correspondence: Narsing A Rao, MD, Doheny Eye Institute, 1450 San Pablo Street, DVRC-211, Los Angeles, CA 90033, USA; nrao{at}hsc.usc.edu

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Carcinoids are a heterogeneous group of tumours believed to arise from enteroendocrine cells scattered primarily throughout the gastrointestinal tract, but these tumours are also found at other sites such as the lungs. Although the term carcinoid underscores the benign nature of the tumour with an indolent course, its potential for metastasis is widely recognised.1,2 The most frequent sites for metastasis include the lymph nodes, liver, and bone.2 Metastasis to the eye and orbit is rare. Gastrointestinal carcinoids tend to metastasise to the orbit while bronchial carcinoids have the propensity to metastasise to the uvea.2,3 The interval between diagnosis of the primary tumour and the recognition of ocular or orbital metastasis varies. The longest reported interval is 24 years for intraocular metastasis, and 15 years for orbital metastasis.1,4 We report on a patient with metastatic carcinoid to the uvea occurring 43 years after excision of the primary bronchial carcinoid and confirmed by histological and immunohistochemical tests, and we propose a mechanism for such delayed metastasis.

Case report

A 65 year old white woman was found to have a superiorly located choroidal mass in the right eye and an inferonasal elevated mass in the left eye on routine examination. Medical history is significant for the diagnosis in 1958 of bronchial adenoma, presently known as bronchial carcinoid. …

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