Abstract
BackgroundMelanoma develops in the cells that produce melanin; ocular melanoma accounts for 3–4% of all malignant melanomas. Thyroid tumors are the most common endocrine neoplasms, with more than 95% of cases arising from follicular cell origin. Previous studies have reported associations between malignant melanoma and a wide variety of malignancies.Case presentationWe report a 54-year-old Iranian woman who was diagnosed with ocular melanoma based on a mushroom-shaped filling defect with homogeneous echo pattern arising from the anterior third of the temporal side of the globe detected on ocular sonography during routine ophthalmological examination. She underwent right globe enucleation and implant replacement. During tumor surveillance, fluorodeoxyglucose positron emission tomography/computed tomography scan showed low-grade metabolically active tumoral involvement in the anterolateral aspect of the right lobe of thyroid. The patient subsequently underwent thyroidectomy and submandibular lymphadenectomy. Pathologic report demonstrated micropapillary carcinoma (9 × 8 mm2), tall cell variant without lymphovascular or perineural invasion in the base of lymphocytic thyroiditis.ConclusionThis case illustrates the importance of precise active surveillance in case of papillary carcinoma of thyroid or malignant melanoma to avoid missing other associated pathologies and emphasizes the simultaneous treatment of two tumors.
Highlights
Melanoma develops in the cells that produce melanin; ocular melanoma accounts for 3–4% of all malignant melanomas
This case illustrates the importance of precise active surveillance in case of papillary carcinoma of thyroid or malignant melanoma to avoid missing other associated pathologies and emphasizes the simultaneous treatment of two tumors
The present study reports another case of this rare cooccurrence of malignant melanoma and papillary thyroid carcinoma, which were treated simultaneously
Summary
Melanoma is a type of cancer that develops from melanin-producing cells, which can arise in the eyes. The present study reports another case of this rare cooccurrence of malignant melanoma and papillary thyroid carcinoma, which were treated simultaneously. Right globe enucleation and implant replacement was performed for the patient; pathologic report revealed 9 × 10 mm malignant melanoma in choroid anterotemporal area with 0–1 mitotic area per 10 high-power fields (HPF) and involvement of anterior chamber and focal retina. High-resolution ultrasonography of the neck soft tissue revealed normal thyroid gland without any sign of solid or cystic lesion, and a suspicious enlarged significant hypoechoic lymph node measuring about 12 × 12 mm in the right jugular chain at zone II. Sonography-guided fine-needle aspiration biopsy of this lesion revealed some clusters of malignant looking cells with high N/C ratio, hyperchromasia, and a few nuclear inclusions, suggestive of malignancy At this time, right-side parotidectomy and fascial nerve trunk exploration and right-side modified neck dissection was performed. The patient is in good health state and takes levothyroxine with daily dose of 125 μg
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