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Chloe TL Khoo, Wasim A Samara, Adel Al Set, Arman Mashayekhi, Emil A Say, Jerry A Shields, Carol L Shields; Fine-Needle Aspiration Biopsy of Solitary Amelanotic Choroidal Tumors in 200 Cases. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5327.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze outcomes of fine-needle aspiration biopsy (FNAB) of indeterminate solitary amelanotic choroidal tumors.
Retrospective case series of 200 eyes with solitary amelanotic choroidal tumors that underwent FNAB.
Of 200 consecutive solitary amelanotic choroidal tumors that underwent FNAB for diagnosis, sufficient sample for a conclusive diagnosis was obtained in 170 (85%). The most frequent diagnoses were choroidal metastasis (81/200, 41%), choroidal melanoma (74/200, 37%), non-specific inflammatory cells (8/200, 4%) and atypical lymphoid cells (3/200, 2%). There were 33 (33/81, 41%) patients with FNAB-proven choroidal metastasis without a known history of primary cancer and further evaluation revealed primary lung carcinoma in 21 (21/33, 64%) and 17 (17/21, 81%) of these patients were smokers. Further, the majority (16/17, 94%) of patients who smoked and did not have prior history of cancer were found to have smoking-related primary cancers (lung = 14/17, 82%; esophagus = 1/17, 6%; kidney = 1/17, 6%) following FNAB. Subgroup analysis showed patients with tumors cytopathologically proven to be choroidal metastasis (versus choroidal melanoma) were more likely to be older (64 vs 59, p = 0.021), have prior history of lung carcinoma (19% vs 0%, p = 0.001), better presenting visual acuity (20/40 vs 20/60, p = 0.024), and have smaller (thickness 4.5 vs 5.4 mm, p = 0.028) tumors. Prior history of breast, kidney, and other systemic cancers, as well as smoking history were not statistically different between both groups.
FNAB is a reliable diagnostic modality for indeterminate solitary amelanotic choroidal tumors. Older patients with prior history of lung carcinoma and smaller solitary amelanotic tumors were more likely to have choroidal metastasis rather than melanoma on cytopathology.
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