Case Study: September 2008

A 16-year-old presents with loss of vision in one eye. Ultrasound shows complete replacement of the intraocular contents with a tumour mass that invades the sclera anteriorly and is present within the episclera.

The H and E images show necrosis (Fig 5) and a biphasic appearance.
One component is shown on Figures 1 and 2 and the other in figures 3 and 4.

Questions

1. What are the arrows in Fig 3 pointing to?
2. What is the diagnosis?
3. Where in the eye does this tumour usually originate from?

Click to show answers
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1. Neural / brain tissue.
2. Malignant teratoid meduloepithelioma.
3. Where the neuro-sensory retina transforms into the non-pigmented epithelium of the pars plana or from the optic nerve head.