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Ophthalmic Images |

Dislocated Crystalline Lens Mimicking Metastatic Endometrial Cancer Online Only

Stanley Park, MD1; Niraj Shah, MD1; Colleen M. Cebulla, MD, PhD1
[+] Author Affiliations
1Havener Eye Institute, Department of Ophthalmology and Visual Science, The Ohio State University Wexner Medical Center, Columbus
JAMA Ophthalmol. 2015;133(9):e151336. doi:10.1001/jamaophthalmol.2015.1336.
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This Ophthalmic Image describes a dislocated crystalline lens that erroneously mimicked metastatic cancer as a complication of homocystinuria.

A woman in her late 50s with a history of metastatic endometrial cancer and homocystinuria was referred for evaluation of a 9 × 6-mm intraocular mass located in the posterior pole of the right eye detected on magnetic resonance imaging of the head. She was asymptomatic in that eye and had poor vision in the left eye from idiopathic choroidal neovascularization. A slitlamp photograph of the right eye showed an inferior, anteriorly located white mass in the posterior segment visible behind her posterior chamber intraocular lens (Figure, A). B-scan ultrasonography revealed a posterior mass with highly echogenic foci associated with an inferior retinal detachment (Figure, B). Dilated examination confirmed a posteriorly dislocated crystalline lens and inferior rhegmatogenous retinal detachment, complications from homocystinuria rather than metastatic endometrial cancer.1 The lesion had position-dependent changes in location between the different imaging modalities.

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Pseudotumor in a patient with homocystinuria. A, Slitlamp photograph shows a white mass behind the posterior chamber intraocular lens. B, B-scan ultrasonography shows a posteriorly located mass with high echogenic signal in its outer aspect sitting on the detached retina.

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