Fine-needle aspiration biopsy diagnosis of a uveal metastasis from a follicular thyroid carcinoma

Purpose: To report a rare tumour of the eye, and to illustrate the importance of performing a fine-needle aspiration biopsy. Case report: An 80-year-old woman suffering from general malaise, dyspnea and abdominal pain was found to have multiple lung metastases, a large tumour in the upper part of the mediastinum, and a large orange-brown tumour (19x15x11 mm) situated nasally in the left eye, Fine-needle aspiration biopsy of the uveal tumour and of the goitre was performed. Cytological examination from the two sites disclosed cells compatible with a follicular thyroid carcinoma of oxyfil cell-type. Results: The patient underwent a total thyroidectomy and has so far had 2 series of I-131 therapy. Additionally, the eye tumour was treated locally with a I-125 plaque, and three months later the tumour thickness had decreased from 11.0 to 6.4 mm. Best-corrected visual acuity is still unchanged. The patient's general state improved as her dyspnea decreased significantly. Conclusion: The treatment has improved the patient's quality of life, and probably prolonged her life expectancy Fine-needle aspiration biopsy was necessary to establish the diagnosis.