Melanocytoma of ciliary body and choroids simulating melanoma

Odashiro, Maçanori; Odashiro, Alexandre Nakao; Leite, Lívio; Melo, Marco Marini; Odashiro, Patricia R.; Miiji, Luciana Nakao Odashiro; Odashiro, Danilo N.; Fernandes, Bruno F.; Burnier, Miguel N

doi:10.1016/j.prp.2009.03.006

Cited by 8 publications

(9 citation statements)

References 17 publications

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“…This is applicable in cases of demonstrated tumor growth mimicking uveal melanoma. Historically, darkly pigmented anterior uveal tumors were not observed due to concern for melanoma and were treated with surgical excision techniques such as iridectomy, iridocyclectomy, and enucleation [11, 22, 23].…”

Section: Discussionmentioning

confidence: 99%

Anterior Uveal Melanocytoma: Role of Diagnostic FNAB

et al. 2022

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Purpose: Anterior uveal melanocytomas (AUM) pose a diagnostic challenge as they can mimic growing melanomas. Establishing a definitive diagnosis of melanocytoma necessitates cytologic or histopathologic confirmation. We describe the clinical presentation and characteristics of fifteen pathologically proven AUM and assess the role of fine needle aspiration biopsy (FNAB) as a safe and effective tool for diagnosis. Methods: Retrospective review of pathologically confirmed AUM cases of iris and/or ciliary body was performed. Demographic data, presenting symptoms, clinical features, diagnostic approach, cytological and histological features, and clinical outcomes were collected. Results: Fifteen patients with pathologically confirmed AUM were identified. Mean and median age of diagnosis were 50 and 53 years, respectively (range 3-77 years). The melanocytoma was localized to the iris (5, 33%), ciliary body (7, 47%), while 3 patients had iridociliary involvement (20%). Four (29%) patients presented because of concern for growth, 10 (64%) were noted incidentally, and visual symptoms were noted in only 1 case (7%). Pigmentation of the tumor varied with 9 tumors (60%) appearing brown and 3 (20%) black tumor. The color of 3 (20%) ciliary body tumors could not be assessed. The diagnosis was confirmed with FNAB in 6 cases (40%), excisional biopsy in 7 cases (47%), and incisional biopsy in 2 cases (13%). Cytologic and histologic preparations both demonstrated predominance of round to polygonal cells with heavily pigmented cytoplasm, and small round nuclei. One patient who underwent excisional biopsy had prior FNAB that was interpreted as suspicious for melanoma (false positive). Instances of false negative cytology were not observed as demonstrated by subsequent stable clinical course during mean follow-up of 21.2 months (range=1-63 months). FNAB related complications were not observed in any case. Conclusion: FNAB offers a minimally invasive and safe diagnostic approach for pathologic confirmation of AUM. However, limitations of FNAB including false-negative and false-positive biopsies must be considered when excluding underlying malignancy. Continued observation to document tumor stability should be considered.

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Section: Discussionmentioning

confidence: 99%

Anterior Uveal Melanocytoma: Role of Diagnostic FNAB

et al. 2022

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“…It is a rare benign pigmented tumor. It is classically described as a tumor of the optic nerve head, but there are some exceptional case reports of uveal tract locations [ 2 – 4 ]. In such cases, it can be difficult to clinically differentiate a melanocytoma from a malignant melanoma.…”

Section: Discussionmentioning

confidence: 99%

“…Melanocytoma is a rare pigmented primary benign tumor that is usually located in the optic disc and the anterior portion of the optic nerve [ 1 ] where the clinical diagnosis is relatively easy. However, in very rare instances, it can be localized in any part of the uveal tract (iris, ciliary body, and choroid) [ 2 – 4 ]. We report the case of a 48-year-old woman with a large choroidal lesion of the left eye.…”

Section: Introductionmentioning

confidence: 99%

Large Choroidal Melanocytoma Simulating Choroidal Melanoma: A Difficult Differential Diagnosis and an Inevitable Enucleation

Abdellaoui¹,

Belfaiza²,

Malek³

et al. 2020

Case Reports in Ophthalmological Medicine

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Purpose. To describe a case of choroidal melanocytoma mimicking a melanoma. Methods. Retrospective case report. Patient. A 48-year-old Moroccan woman presented with progressive, painless decreased vision in her left eye for 2 months. Results. Her visual acuity was light perception in the left eye and 20/20 in the right one. Fundus examination and fluorescein angiography of the left eye showed a total retinal detachment with a large superior brownish mass. The clinical examination, B-scan ultrasonography, and magnetic resonance imaging all suggested a malignant melanoma. Consequently, the eye was enucleated. The histopathology later revealed a benign melanocytoma of the choroid. Discussion. Melanocytoma is a rare benign pigmented tumor. It is classically described as a tumor of the optic nerve head, but there are some exceptional case reports of uveal tract locations (iris, ciliary body, and choroid). In such cases, it can be difficult to clinically differentiate a melanocytoma from a malignant melanoma.

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“…The clinical diagnosis of CB melanocytoma can be challenging and often resulting in enucleation with the presumed diagnosis of a melanoma 8 . However, nowadays better diagnostic techniques may help in reaching the proper diagnosis and planning for better management such as UBM, anterior segment optical coherence tomography (OCT), MRI and fine needle aspiration biopsy (FNAB) [5], [9], [10].…”

Section: Discussionmentioning

confidence: 99%

Acute subconjunctival pigmentation with an underlying ciliary body mass: An unusual case presentation

Alkatan

Fathaddin

Mahmood

et al. 2019

Saudi Journal of Ophthalmology

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Intraocular melanocytoma is a rare slowly growing benign tumor that may occur anywhere along the uveal tract including the ciliary body but is more commonly found near the optic disc. It is darkly pigmented and may exhibit fast growth and possibly malignant transformation. Ciliary body (CB) melanocytoma is rare and often misdiagnosed as a melanoma. We are reporting a case of CB melanocytoma in a 74-year old lady with unusual initial presentation of an acute onset of subconjunctival pigmentation and extra-scleral extension of the melanocytoma with coarse melanin granules. The diagnosis of melanocytoma was confirmed by histopathological examination of the prolapsed tissue and by ultrastructural studies. Literature review of similar cases is also summarized.

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Melanocytoma of ciliary body and choroids simulating melanoma

Cited by 8 publications

References 17 publications

Anterior Uveal Melanocytoma: Role of Diagnostic FNAB

Anterior Uveal Melanocytoma: Role of Diagnostic FNAB

Large Choroidal Melanocytoma Simulating Choroidal Melanoma: A Difficult Differential Diagnosis and an Inevitable Enucleation

Acute subconjunctival pigmentation with an underlying ciliary body mass: An unusual case presentation

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