Iris Melanocytoma Research Articles

Iris Melanocytoma with Minimal Change over 50 Years

Iris Melanocytoma with Minimal Change over 50 Years

Spontaneous Regression of Presumed Iris Melanocytoma

A 45-year-old man was referred for a unilateral pigmented iris lesion. Examination of the right eye showed a visual acuity of 20/20 and intraocular pressure of 14 mmHg. On slit-lamp biomicroscopy, a darkly pigmented, elevated lesion was observed in the peripheral iris (Fig A). Ultrasound biomicroscopy revealed a solid lesion in the peripheral iris with a thickness of 1.6 mm (Fig B). The mass was presumed to be an iris melanocytoma. Four years later, a divet developed centrally, and the thickness of the lesion decreased to 0.9 mm (Fig C–D).

Iris melanocytoma in child diagnosed by fine needle aspiration biopsy

We report a case of large iris melanocytoma in a child diagnosed by fine needle aspiration biopsy. In this interventional case report, cytologic features typical of melanocytoma were obtained by fine needle aspiration biopsy (FNAB). FNAB can be used in difficult diagnostic cases if a good sample is obtained, this technique has an accuracy of more than 99% in tumors larger than 3mm; however, false-negative and false-positive results may be obtained. Its risk of local spread is very small, an advantage over incisional biopsy. The most common complication is intralesional hemorrhage and hyphema.

Clinical and Ultrasound Biomicroscopic Features in Iris Melanocytoma

The clinical and ultrasound biomicroscopic features of two cases of iris melanocytoma are evaluated. On ultrasound biomicroscopy examination, iris melanocytoma appears as a highly reflective nodular mass with a smooth or irregular surface and sharp and well-defined edges. Ultrasound biomicroscopy also allows clear visualization and measurement of the tumors. These findings were compared with clinical and histopathologic findings.

Diode Laser Transscleral Cyclophotocoagulation in the Treatment of Refractory Glaucoma with Iris Melanocytoma

Iris melanocytoma is a rare melanocytic nevus with distinctive clinical and pathologic features. Secondary glaucoma may develop rapidly and respond poorly to glaucoma medication in some cases. However, few data are available in the literature with respect to the appropriate treatment for refractory glaucoma associated with iris melanocytoma. Herein, we present a 28-year-old man with blurred vision and an elevated intraocular pressure (IOP) of 40 mmHg in his right eye while on multiple glaucoma medications. A dark brown lobulated iris mass with surrounding small pigmented lesions was noted between the 4 and 5:30 o'clock positions. Sector iridectomy was performed and pathologic examination revealed an iris melanocytoma. After surgery, antiglaucomatous medications still failed to control IOP. The patient then underwent diode laser transscleral cyclophotocoagulation (TSCP). At the last follow-up of 15 months, IOP had returned to normal without the need for medication.

Surgical management of a progressive iris melanocytoma in a Mustang

A 7-year-old gray Mustang gelding weighing 454 kg was presented for evaluation of a brown mass within the left eye (OS) of 1 year's duration with recent enlargement. A nonpainful, 8 mm diameter, brown, vascularized mass was identified in the anterior chamber of the OS. Ocular B-scan ultrasound confirmed iris involvement and corneal endothelial contact. Histopathology confirmed the presumptive diagnosis of a uveal melanocytic neoplasm, and revealed 1-3 mitotic figures per high power (400x) field. The mass was removed via sector iridectomy without complications, but without complete margins. Three cutaneous melanocytomas noted 1.5 months postoperatively were completely excised. No tumor regrowth was noted 15 months postoperatively, supporting a diagnosis of melanocytoma for the iridal mass. Sector iridectomy is a reasonable treatment option for uncomplicated iridal melanocytomas in horses. Mitotic index and presence of cutaneous melanocytic neoplasms may be irrelevant to the prognosis of equine iridal melanocytic neoplasms.

Malignant transformation of iris melanocytoma to iris ring melanoma

Melanocytoma, a benign uveal melanocytic tumour, represents only 3% of iris naevi, and seldom undergoes malignant transformation.1 2 We report an unusual case of an iris melanocytoma suggested by two...

Iris Melanocytoma Mimicking the Cogan-Reese Syndrome with Monocular Pigment Dissemination

To report a case of iris melanocytoma mimicking the Cogan-Reese syndrome. A 37-year-old woman presented with pigmentary glaucoma in her left eye. There was diffuse pigmentary dispersion in the anterior segment, pedunculated pigmented nodules on the anterior iris surface, mild iris atrophy, and ectropion iridis. Neither intrinsic vasculature nor a sector cataract was found. The angle was open with marked trabecular pigmentation and no anterior synechiae. The intraocular pressure was 30 mmHg with maximum medical treatment and there was glaucomatous optic atrophy. The differential diagnosis included iris pigmented tumor and iridocorneal endothelial syndrome (Cogan-Reese syndrome). An iris biopsy was performed for diagnostic purposes. Histologic diagnosis after evaluation of the specimen was iris melanocytoma. This case presents signs considered quasi-pathognomonic of iridocorneal endothelial syndrome (Cogan-Reese syndrome): glaucoma, mild iris atrophy associated with pedunculated iris nodules, and ectropion iridis. Therefore, iris melanocytoma can present with features that mimic the Cogan-Reese syndrome.

Iris Melanocytoma: Clinical Features and Natural Course in 47 Cases

Iris Melanocytoma: Clinical Features and Natural Course in 47 Cases

Iris melanocytoma: Clinical features and natural course in 47 cases

To describe the clinical features, natural course, management and histopathologic features of iris melanocytoma. Single-center retrospective case series. Forty-seven consecutive patients (47 eyes) with iris melanocytoma. INTERVENTION PROCEDURE: Data regarding patient and tumor features were analyzed for their impact on the main outcome measures using univariate and multivariate regression models. Kaplan-Meier estimates were used to analyze the main outcomes as a function of time. Increased intraocular pressure (IOP), tumor seeding, and tumor growth. Associated findings at initial presentation included iris stromal seeds in 20 patients (43%), and anterior chamber angle seeds in 12 (26%). Intrinsic vascularization and sector cataract were not seen in any eyes. The management at presentation included observation in 39 patients (83%), tumor removal by sector iridectomy/iridocyclectomy in 7 (15%), and enucleation for blind painful eye with secondary increased IOP in 1 (2%). The diagnosis was confirmed by histopathologic examination in 11 patients (23%). The mean follow-up was 58 months. Using Kaplan-Meier estimates, clinical evidence of growth was observed in 23% at 5 years, 48% at 10 years, and 74% at 15 years. New tumor seeds developed in 34% at 5 years, 63% at 10 years, and 75% at 15 years. Increased IOP was observed in 11% at 5 years, 11% at 10 years, and 55% at 15 years. Iris melanocytoma represented only 3% of all iris nevi. Related iris stromal and anterior chamber angle seeds were common, and secondary glaucoma occurred in 11% at 5 years. Growth was observed in 23% at 5 years but no malignant transformation was found.

Progressive growth of an iris melanocytoma in a child

PURPOSE: To document progressive growth of a benign iris melanocytoma.METHODS: Interventional case report. A 9-year-old male underwent removal of a pigmented iris tumor that had been documented photographically to double in size.RESULTS: Histopathologic sections revealed a deeply pigmented mass with cytologic features typical of a melanocytoma.CONCLUSION: Although iris melanocytoma is generally a stationary lesion, it can show progressive growth. Such enlargement does not necessarily imply malignant transformation of the lesion.

Melanocytomalytic glaucoma in eyes with necrotic iris melanocytoma

Objective Iris melanocytoma, although histologically benign, may undergo spontaneous necrosis with the resultant pigment dispersion causing secondary open-angle glaucoma. The authors describe the clinical findings in three patients with this syndrome and review the current literature. Design The study design was a small case series. Participants Three patients with secondary glaucoma caused by a necrotic iris melanocytoma participated. Intervention Clinical records and pathologic preparations were reviewed. The diagnosis of iris melanocytoma was confirmed by histopathologic examination in all three cases. Results All patients had intrinsically pigmented localized iris tumors and pigmentation of the angle. Hyperchromic heterochromia iridum was noticeable in all patients. In two instances, a central crater in the lesion signified tumor necrosis. Two patients were treated successfully by surgical resection of the iris tumor and the glaucoma resolved. One patient was treated with enucleation. In all patients, histopathologic analysis disclosed extensively necrotic tumor comprised of maximally pigmented nevus cells with bland nuclei and infiltration of the trabecular meshwork by melanophages. Conclusion Secondary glaucoma may result from obstruction of the trabecular meshwork with necrotic iris melanocytoma. Resection of the tumor may relieve the glaucoma.

Necrotic Melanocytoma of Iris with Secondary Glaucoma

A 23-year-old white man had a pigmented iris tumor that was not enlarging; it produced satellite iris lesions, diffuse pigmentation of the trabecular meshwork, and secondary glaucoma. Although enucleation was initially recommended, we chose to remove only the primary lesion with a sector iridectomy. Histologically, the lesion proved to be a benign melanocytoma that had undergone extensive necrosis. Postoperatively, the satellite lesions, pigmentation in the angle, and glaucoma all resolved.