case_images: PMC11810680_01
case_images: Photograph of the fundus. This photograph shows a choroidal mass with elevation adjacent to the optic disc.
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case_images: FIG1
case_images: Fundus examination revealed an elevated choroidal mass adjacent to the optic disc (Figure 1).
case_images: Axial CT scan. CT reveals a well-circumscribed ovoid choroidal mass inside the right eyeball, measuring 8 x 12 x 11 mm (arrow). It was iso-attenuated compared to the lateral rectus muscle with infiltration into the internal rectus muscle, which was a suspected extra-scleral extension.
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case_images: PMC11810680_01_cureus-0017-00000077299-i02.jpg
case_images: FIG2
case_images: The lesion was an oval and well-circumscribed choroidal mass, measuring 8 x 12 x 11 mm, with suspected extra-scleral extension (Figure 2).
case_images: Axial MR images. T1-weighted image (a) shows a choroidal mass with homogeneously isointense signal intensity compared with the cerebral cortex (white arrow).. T2-weighted image (b) reveals that the mass is heterogeneous, mixed with hypointense and hyperintense signal intensities relative to the cerebral cortex (black arrow).
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case_images: FIG3
case_images: MRI revealed that the lesion had homogeneously isointense signal intensity compared with the cerebral cortex on T1-weighted images (Figure 3a). On T2-weighted images, the mass exhibited heterogeneous mixed hypointense and hyperintense signal intensities relative to the cerebral cortex (Figure 3b).
case_images: Axial DCE-MRI (a) and TICs (b). Axial DCE MRI (a) reveals that the mass has a heterogeneous enhancement (arrow).. The TICs (b) are characterized by two types: early enhancement and washout (1) and persistent enhancement (2).. 1 = margin of the mass (yellow ROI), 2 = center of the mass (red ROI).. DCE-MRI: dynamic contrast-enhanced magnetic resonance imaging; TICs: time-intensity curves; ROI: region of interest
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case_images: FIG4
case_images: The lesion exhibited heterogeneous enhancement on contrast-enhanced MRI (Figure 4a). T2-weighted images showed a marked enhancement and a washout pattern on TICs. The TIC of the hypointense signal areas on the T2-weighted images was characterized by a persistent enhancement curve (Figure 4b).
case_images: Cross-sectional view of the enucleated eye. The image reveals a multinodular lesion, measuring 12.5 x 10 mm, expansively protruding from the sclera into the vitreous.
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case_images: FIG5
case_images: Figure 5 and Figure 6 show the histopathological findings. The mass protruded into the vitreous with extra-scleral extension (Figure 5).
case_images: Hematoxylin and eosin (H&E) and immunochemical staining. Spindle cell tumor with patternless growth of various densities, occasionally intervened by thick collagen fibers (a,b).. Immunohistochemistry of CD34 highlights the sinusoidal vascular spaces lined by flattened endothelial cells (c).. The tumor cells are diffusely positive for STA6 (d).
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case_images: FIG6
case_images: Figure 5 and Figure 6 show the histopathological findings. Histological sections revealed dense fascicular proliferation of neoplastic spindle cells accompanied by a rich sinusoidal vasculature and a collagenous fiber background (Figure 6a and Figure 6b). On immunohistochemical staining, the tumor cells were strongly and diffusely positive for CD34 (Figure 6c) and STAT6 (Figure 6d), consistent with SFT.