Iris Metastasis From Systemic Cancer in 104 Patients

Abstract

Metastatic tumors to the iris generally originate from primary malignancies in the breast, lung, or skin (melanoma). Despite successful ocular treatment, life prognosis is poor.

Iris metastasis as the first sign of small cell lung cancer: A case report

“…Tumors are likely to be unilateral and may be associated with a variety of other symptoms, including glaucoma, abnormal vascularization, hyphema, ectropion, pigment dispersion, pseudohypopyon, iridocyclitis and pupillary distortion (15). A careful evaluation of any underlying malignancy is warranted if a patient exhibits unilateral anterior uveitis or intractable glaucoma (2). …”

“…Patients should be promptly referred to a general oncologist and onco-ophthalmologist for further treatment and systemic examination (23). Generally, treatment of anterior segment tumors usually consists of ocular conservation and treatment options for iris metastasis typically include surgical excision, plaque radiotherapy, external beam radiotherapy or systemic chemotherapy (2). Ocular outcome in patients with iris metastasis is largely favorable in 95% of cases (2); however, overall prognosis is determined by systemic neoplastic disease.…”

“…Generally, treatment of anterior segment tumors usually consists of ocular conservation and treatment options for iris metastasis typically include surgical excision, plaque radiotherapy, external beam radiotherapy or systemic chemotherapy (2). Ocular outcome in patients with iris metastasis is largely favorable in 95% of cases (2); however, overall prognosis is determined by systemic neoplastic disease. Therefore, clinicians must balance optimism with a more realistic outlook of a shortened patient lifespan.…”

“…Choroidal metastasis is the most frequent type, whereas metastases in the iris, ciliary body, retina, vitreous and optic disc are all comparatively rare (1). Metastatic carcinoma of the iris may be one of the first indications of disseminated malignant disease, and its accurate differential diagnosis is important due to poor patient prognosis (2). Novel imaging methods, including ultrasonography (color Doppler) and contrast-enhanced ultrasound (CEUS), have been developed not only to improve the early detection of malignant infiltrations, but also to improve the evaluation of tumor vascularity to diagnose an unknown primary.…”

Iris metastases from systemic cancer: a report of three cases

“…A previous report suggests that the frequency of macroscopic metastases has decreased over 12 years from 4.7% to 1% owing to improved cancer therapy (2) . Uveal metastases occur far more frequently in the choroid than in the iris, possibly due to the substantial blood supply to the posterior choroid by the posterior ciliary arteries (3) . Metastatic tumors to the iris are relatively uncommon; they may present as stromal nodules or ill-defined iris thickening, or they may be associated with atypical features such as pain, iridocyclitis, and hyphema (4,5) .…”