PMC10447162_01
Transverse (a) and coronal (b) view of the orbit showing an 18 x 14 x 9 mm homogeneously enhancing mass (arrows) within the right globe.
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Subsequent magnetic resonance imaging (MRI) of the orbits identified an 18 x 14 x 9 mm homogeneously enhancing mass within the right globe, with its base at the posterior superior wall and extending exophytically into the vitreous of the posterior chamber with the suggestion of invasion through the superior wall of the orbit and into the surrounding orbital fat (Figures 1(a) and 1(b)).
Transverse (a) and sagittal (b) view of the left lobe nodule on thyroid US. This nodule is a hypoechoic, solid, vascular lesion with inhomogeneous appearance, poorly defined border and coarse calcification.
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TI-RAD 5 nodules were hypoechoic, solid, vascular lesions with inhomogeneous appearance and poorly defined borders. The left lobe dominant nodule also had coarse calcification (Figures 2(a) and 2(b)).
The thyroid fine needle aspirate (FNA) showed poorly cohesive epithelioid cells in a background of blood ((a) smear, papanicolaou stain, original magnification x400). The tumor cells had abnormal chromatin content, prominent nucleoli, and dense cytoplasm ((b) thinprep, papanicolaou stain x600). Same appearing tumor cells on cell block ((c) H&E stain, original magnification x600). The tumor cells were positive for cytoplasmic melan-A stain ((d) immunohistochemical stain, original magnification x600).
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The ultrasound-guided FNA of the right dominant nodule was nondiagnostic twice but showed malignant cells the third time (Figures 3(a) and 3(c)). The atypical epithelioid cells were notable for overall large size with relatively preserved nuclear-to-cytoplasmic ratio, abnormal chromatin content, prominent nucleoli, and dense cytoplasm (Figure 3(b)).