Circumscribed irido‐ciliary melanoma: surgery versus irradiation

Abstract

SummaryIris tumors include congenital benign cyst, naevi, melanocytomas malignant melanomas, benign adenoma,leiomyomas, metastatic tumors, iris location of leukemia or lymphomas and histiocytic proliferations like iris xanthogranuloma.Patients with metastatic disease rarely develop a bilateral diffuse melanocytic uveal proliferation (BDUMP) which can cause retinal detachment and blindness.The diagnosis of an iris tumor is made by careful medical history, slit lamp examination, UBM ultrasonography and OCT of the iris.In rare instances fine needle aspiration biopsy can be useful but follow up is often the more important test to differentiate stable naevus versus malignant melanoma of the iris.Treatment can be a simple observation for naevi or melanocytoma..Surgery is still the best option for adenomas and leiomyomas. Metastatic disease can be treated by chemotherapy and external beam radiation. Xanthogranulomas of the iris usually respond well to steroids. For melanoma of the iris a lot of centers do not use surgery and prefer radiotherapy most often proton beam radiotherapy. Results of proton beam therapy of iris melanoma will be presented.