Adult ocular medulloepithelioma diagnosed by transscleral fine needle aspiration: A case report

Ocular medulloepithelioma (ME) is a rare congenital tumor which occurs usually during childhood but is also reported in adults. They have seen an intraocular tumor in an 89 years‐old female with a history of small cell lung carcinoma. Transscleral fine needle aspiration was performed. Aspirates were rich and composed of two distinctive populations of cells. The first consisted of epithelioid large cohesive cells with rare rosettes. Nuclei were oval and chromatin was delicate with small nucleoli. The second population consisted of smaller and dispersed cells with regular nuclei and dusty chromatin. Immunohistochemistry performed on paraffin‐embedded cell block sections showed that the larger cells and rosettes were cytokeratin AE1/AE3, Synaptophysin, Chromogranin A, CD56, NSE, and EMA positive, whereas the smaller cells were always negative. Interestingly smaller cells expressed only weak nuclear positivity for TTF1, whereas larger cells were TTF1 negative. Melanocytic markers were negative in both populations. Morphological patterns and immunohistochemical staining confirmed ocular ME and allowed to exclude pulmonary metastasis or primary malignant melanoma. The patient was successfully treated by brachytherapy alone and is alive and well 10 months after treatment. Diagn. Cytopathol. 2017;45:561–564. © 2017 Wiley Periodicals, Inc.

[1]  R. Verdijk On the Classification and Grading of Medulloepithelioma of the Eye , 2016, Ocular Oncology and Pathology.

[2]  Nathalie Cassoux,et al.  Fine Needle Aspiration Biopsy in Uveal Melanoma: Technique, Complications, and Outcomes. , 2016, American journal of ophthalmology.

[3]  Daniel S. Poon,et al.  Ruthenium-106 Plaque Brachytherapy in the Primary Management of Ocular Medulloepithelioma. , 2015, Ophthalmology.

[4]  Ivana K. Kim,et al.  Immunohistochemical investigations of adult intraocular medulloepitheliomas , 2015, Clinical & experimental ophthalmology.

[5]  D. Vanderveen,et al.  New insights into the development of infantile intraocular medulloepithelioma. , 2014, American journal of ophthalmology.

[6]  C. Shields,et al.  Ciliary body medulloepithelioma: analysis of 41 cases. , 2013, Ophthalmology.

[7]  M. Ali,et al.  Ciliary body medulloepithelioma in an adult. , 2013, Survey of ophthalmology.

[8]  S. Mathur,et al.  Fine needle aspiration cytology of metastatic ocular medulloepithelioma , 2011, Cytopathology : official journal of the British Society for Clinical Cytology.

[9]  L. Desjardins,et al.  Conservative surgical treatment of medulloepithelioma of the ciliary body. , 2010, Archives of ophthalmology.

[10]  N. Eide,et al.  Fine‐needle aspiration biopsy and other biopsies in suspected intraocular malignant disease: a review , 2009, Acta ophthalmologica.

[11]  MORTON E. Smith,et al.  Fine Needle Aspiration Biopsy with Adjunct Immunohistochemistry in Intraocular Tumor Management , 2005, Acta Cytologica.

[12]  P. Dey,et al.  Medulloepithelioma of ciliary body diagnosed by fine needle aspiration cytology , 2003, Cytopathology : official journal of the British Society for Clinical Cytology.

[13]  P. Wakely,et al.  Management of medulloepithelioma of the ciliary body with brachytherapy. , 2002, American journal of ophthalmology.

[14]  A Brun,et al.  Tumours of the Central Nervous System , 1986, Acta radiologica: diagnosis.

[15]  B. Streeten,et al.  Malignant teratoid medulloepithelioma in an adult. , 1979, Archives of ophthalmology.

[16]  F. Verhoeff,et al.  Verhoeff's "terato-neuroma" a critical reappraisal in light of new observations and current concepts of embryonic tumors. , 1971, Transactions of the American Ophthalmological Society.

[17]  R. Barnard,et al.  The classification of tumours of the central nervous system. , 1982, Neuropathology and applied neurobiology.

[18]  L. Zimmerman Verhoeff's "terato-neuroma". A critical reappraisal in light of new observations and current concepts of embryonic tumors. The Fourth Frederick H. Verhoeff Lecture. , 1971, American journal of ophthalmology.