Pseudo-pigmented choroidal schwannoma with extraocular extension in an elderly patient

Arnulfo Garza Reyes; Chad Y. Lewis; Chau Pham; H. Culver Boldt; Lola P. Lozano; Nasreen A. Syed; Elaine M. Binkley

doi:10.1016/j.ajoc.2024.102137

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Pseudo-pigmented choroidal schwannoma with extraocular extension in an elderly patient

Journal article

Open access

Peer reviewed

Pseudo-pigmented choroidal schwannoma with extraocular extension in an elderly patient

Arnulfo Garza Reyes, Chad Y. Lewis, Chau Pham, H. Culver Boldt, Lola P. Lozano, Nasreen A. Syed and Elaine M. Binkley

American journal of ophthalmology case reports, Vol.36, 102137

12/2024

DOI: 10.1016/j.ajoc.2024.102137

PMCID: PMC11365291

PMID: 39220379

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Abstract

To describe a rare case of clinically pigmented choroidal schwannoma with extraocular extension in an elderly patient. We report a case of a 79-year-old Black male who presented with a clinically pigmented, juxtapapillary choroidal tumor with concern for extraocular extension on standardized ocular echography. The lesion was concerning for choroidal melanoma with extraocular extension. He had no history of cancer or known genetic disease. After an extensive discussion of management options, he underwent enucleation of the left eye. Histopathology of the tumor showed non-pigmented cells with bland, spindle-shaped nuclei and areas of Antoni A pattern along with immunostaining consistent with choroidal schwannoma with extraocular extension. Choroidal schwannoma can mimic choroidal melanoma and can have a clinically pigmented appearance particularly in darkly complected individuals. This case highlights the importance of including choroidal schwannoma on the differential diagnosis for choroidal neoplasms, particularly in populations of individuals in whom melanoma is less common. Though more common in younger patients, choroidal schwannoma can present in elderly patients.

Antoni A

Choroidal tumor

Extraocular extension

Optical coherence tomography

Schwannoma

Standardized ocular ultrasound

Details

Title: Subtitle: Pseudo-pigmented choroidal schwannoma with extraocular extension in an elderly patient
Creators: Arnulfo Garza Reyes - Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
Chad Y. Lewis - Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
Chau Pham - University of Iowa
H. Culver Boldt - Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
Lola P. Lozano - University of Iowa
Nasreen A. Syed - Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
Elaine M. Binkley - Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
Resource Type: Journal article
Publication Details: American journal of ophthalmology case reports, Vol.36, 102137
Publisher: Elsevier Inc
DOI: 10.1016/j.ajoc.2024.102137
PMID: 39220379
PMCID: PMC11365291
ISSN: 2451-9936
eISSN: 2451-9936
Language: English
Date published: 12/2024
Academic Unit: Pathology; Ophthalmology and Visual Sciences
Record Identifier: 9984696855702771

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