Iris melanoma: pathology, prognosis and surgical intervention

Starr, Oliver D; Patel, Dipika V.; Allen, Jonathan P.; McGhee, Charles N J

doi:10.1111/j.1442-9071.2004.00821.x

Cited by 11 publications

(8 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinical differentiation between benign and malignant iris lesions can be difficult and there is no universally accepted classification of iris naevi and melanomas 7 . Other conditions presenting with iris nodules and elevated intraocular pressure include Fuch's heterochromic iridocyclitis, neurofibromatosis, Cogan‐Reese syndrome and uveitic conditions such as sarcoidosis.…”

mentioning

confidence: 99%

Tapioca melanoma of the iris

Pick

Wilson²

2009

Clinical and Experimental Optometry

View full text Add to dashboard Cite

mentioning

confidence: 99%

Tapioca melanoma of the iris

Pick

Wilson²

2009

Clinical and Experimental Optometry

View full text Add to dashboard Cite

“…The surgical intervention might then have been less invasive, resulting in less stretching of the sclera in closing the wound and consequently less astigmatism than is the case presently. Other reported cases of iris melanomas had smaller tumours, which had not invaded the angle (Cialdini et al, 1989; Starr et al, 2004).…”

Section: Discussionmentioning

confidence: 94%

Iris melanoma: a case report and review

Millodot

Hendler

Pe’er

2005

Ophthalmic Physiologic Optic

View full text Add to dashboard Cite

Iris melanoma is a rare ocular tumour, which can be detected early in its development. This tumour is almost always unilateral and arises usually from a pre-existing naevus. Failure to detect it may be associated with morbid ocular and systemic complications, yet there are successful therapies to treat this condition, if detected early. The patient presented to the eye clinic with symptoms of occasional, brief loss of vision in his left eye for a few weeks prior to his visit. Slit-lamp examination revealed a mass on the inferior part of the iris of the left eye. Intra-ocular pressure measurements were RE 15 mmHg and LE 38 mmHg. It was found that a tumour had spread throughout the iris stroma and invaded the anterior chamber angle. Although enucleation would have been the treatment of choice in the past, the trend today in the treatment of a growing, large circumscribed iris tumour is to excise it. It was successfully excised by irido-cyclo-trabeculectomy.

show abstract

“…4 Should growth accelerate and the lesion remain well circumscribed, local excision may be a treatment option. 5 This case highlights an initially 'closed globe' practical approach to the controlled excision biopsy of large iris tumours with microsurgical instruments. The surgical technique enabled a large excisional biopsy of the iris tumour initially via two 1.2 mm paracenteses, with greater control of the iris and protection of the adjacent lens and cornea, as opposed to surgical techniques that initially use a large corneal/ sclerocorneal incision to gain access to iris lesions.…”

Section: Commentmentioning

confidence: 96%

“…If the lesion appears static or very slow growing, careful observation with serial photography is generally recommended . Should growth accelerate and the lesion remain well circumscribed, local excision may be a treatment option …”

Section: Commentmentioning

confidence: 99%

Conservative biopsy excision and management of a large iris melanoma

Chong

Patel

Hadden

et al. 2014

Clinical and Experimental Optometry

Self Cite

View full text Add to dashboard Cite

A 68-year-old man was referred with a right iris lesion, present for 10 years with noticeable growth over the last 24 months. Visual acuity (VA) was 6/6 bilaterally with normal intraocular pressures. A large inferonasal pigmented iris tumour was observed extending from 2:30 to 6 o'clock on the right iris ( Figure 1A). The lesion was raised, creamy coffee-coloured and associated with corectopia but not iris or angle neovascularisation ( Figure 1B). Gonioscopy showed the lesion adjacent to the angle but without visible encroachment of angle structures (dynamic gonioscopy), from approximately 3 to 5 o'clock ( Figure 1C). High-frequency ultrasound showed no macroscopic involvement of the ciliary body. Systemic review revealed no metastatic lesions and no history of systemic melanoma.Due to high suspicion of iris melanoma, surgical excision biopsy was performed, as the patient's preferred management, after careful discussion of options, including continued observation, localised external plaque radiotherapy, proton beam radiotherapy and laser photocoagulation. The major differential diagnosis of this iris lesion was an enlarging benign iris naevus.To minimise distortion and manipulation of the iris, with the potential to damage adjacent ocular structures and dispersion of tumour cells, an initial 'closed globe' approach was employed. Two small (1.2 mm), peripheral, temporal corneal paracenteses were made opposite the upper and lower margins of the lesion. The anterior chamber was filled with a large cushion of viscoelastic to elevate the iris away from the crystalline lens and to protect the corneal endothelium. The iris was incised radially from pupil to base via the paracenteses using microsurgical intraocular scissors and forceps. Thereafter, a large, stepped nasal corneal incision (145°) was made to enable excision of the tumour at the iris root. Five clock hours of the iris was removed without injury to lens, cornea or angle.Histology confirmed a malignant iris melanoma of mixed cell type, predominantly spindle B-cells with the tumour extending to the nasal excision margin. The latter was indicative of the potential of residual ocular tumour at the nasal margin. The lesion was further assessed and was focally positive for S100, diffusely positive for HMB45 but KI-67 negative. Fluorescence in situ hybridisation analysis confirmed

show abstract

Iris melanoma: pathology, prognosis and surgical intervention

Cited by 11 publications

References 15 publications

Tapioca melanoma of the iris

Tapioca melanoma of the iris

Iris melanoma: a case report and review

Conservative biopsy excision and management of a large iris melanoma

Contact Info

Product

Resources

About