Juvenile xanthogranuloma of the iris treated with proton beam radiotherapy.

Abstract

AbstractPurpose To report a case of juvenile xanthogranuloma of the iris treated with proton beam radiotherapy.Methods An 18‐year‐old male presented in October 2010 with blurred vision of the left eye. Clinical examination showed a hyphaema. A yellow‐pink tumour was noted in the temporal aspect of the iris. Ultrasonography showed the tumour to have a low internal reflectivity, measuring 7.8mm by 6.4mm in basal diameter with a thickness of 1.4mm. The lesion was noted to be extending to the pars plana. Incisional biopsy showed the tumour confirmed a diagnosis of juvenile xanthogranulomatosis. Treatment with topical steroids was unsuccessful. The patient was therefore treated with proton beam radiotherapy, comprising 18 Gy delivered in four fractions, penetrating to 4mm. Margins of 8mm around the lesion were also treated.Results The patient was followed up in March 2011 where significant tumour shrinkage was observed on slitlamp examination. The response to treatment was confirmed on ultrasound. There were no new lesions and no evidence of anterior chamber activity. The patient remains under review.Conclusion Proton beam therapy is an effective alternative local treatment for this condition.