Novel presentation of intraocular metastases in a patient with penile squamous cell carcinoma: a case report
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CASE REPORT
Open Access
Novel presentation of intraocular metastases in a patient with penile squamous cell carcinoma: a case report Shanshan Li, Haifeng Zhao, Cui Qiu and Changfan Wu*
Abstract Background: The choroid is the most common site for intraocular tumor metastasis because of its abundant vascular supply. However, choroidal metastasis in penile cancer is highly unusual. Here, we report the first case of diagnosis of choroidal metastasis at presentation in a patient with penile squamous cell carcinoma. Case presentation: A 43-year-old Asian man with a 3-year history of penile cancer presented with metastasis in the right intraocular sites. Magnetic resonance imaging showed hyperintensity in the T1-weighted images and hypointensity in the T2-weighted images of the right eye. After enucleation of his right eye, histopathological analysis led to a diagnosis of metastatic, moderately differentiated penile squamous cell carcinoma. Conclusions: Penile cancer typically occurs as penile squamous cell carcinoma, and its most common metastatic sites are the inguinal lymph nodes. Hemorrhagic transfer of tumor cells is extremely rare, especially to intraocular sites. Intraocular metastatic tumors have a unique presentation on imaging, as observed on magnetic resonance imaging and histopathological analysis. This novel finding of intraocular metastasis in penile squamous cell carcinoma is of great significance to optic surgeons and oncologists as it has new implications in the diagnosis of and timely intervention for penile cancer metastasis. Keywords: Penile cancer, Intraocular oncology, Choroidal metastases, Metastasis
Background Penile cancer (PC) is a rare cancer type in Europe, with an incidence of less than 1%. However, in parts of Asia, it may be account for as high as 10% of adult male cancers [1, 2]. PC initially spreads to the superficial and deep inguinal lymph nodes, and then follows a predictable pattern of distant metastasis via the lymphatic network [3–6]. However, tumor-cell dissemination through the blood is rare [3, 4, 7]. Research has shown that the lung and breast are the most frequent sites for PC metastasis, and other metastasis sites include the liver, brain, heart, skin, and bones [8–10]. Nevertheless, choroidal metastasis in PC is * Correspondence: [email protected] Department of Ophthalmology, Yijishan Hospital of Wannan Medical College, Wuhu 24000, China
infrequent [3, 4]. Here, we present the first case report in the literature, to the best of our knowledge, of intraocular metastasis in a patient with PC, as confirmed with the patient’s clinical manifestation and magnetic resonance imaging (MRI) characteristics, as well as histopathology.
Case presentation On January 31, 2015, a 43-year-old Asian man with a 3year history of progressively invasive PC presented with pain in his right eye. Our patient, who had been staged T4N3M1(TNM classification), had also lost his vision more than a month earlier. He was diagnosed as having metastasis in the bilateral inguinal lymph nodes and ipsilater
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