advertisement
BACKGROUND: Ferry et al. showed that 35% of eyes that have been enucleated because of a clinically suspected malignant iris lesion did not reveal a histologically malignant iris tumor. PATIENT: A 43-year-old male presented with a blind, painful left eye, which had developed over a time period of six months. Ophthalmological examination revealed the presence of pigmented iris stromal lesions associated with diffuse pigmentation of the chamber angle and the development of absolute glaucoma. A diffuse iridociliary malignant melanoma (ring melanoma) was suspected, and the blind painful eye enucleated. Histological examination revealed the presence of a benign melanocytic lesion, i.e., a spindle cell nevus of the iris with surface plaques causing diffuse extension of the chamber angle, trabecular meshwork, Schlemm's canal, and the ciliary body. CONCLUSIONS: The malignant potential of iris lesions may be difficult to assess on clinical grounds only. Histologically, benign melanocytic proliferation may cause diffuse extension into the ciliary body as well as the chamber angle, leading to an increase in intraocular pressure. In order to reach a final diagnosis, a biopsy of the lesion is necessary. LA: German
Dr C.W. Spraul, Universitäts-Augenklinik Ulm, Prittwitzstrasse 43, 89075 Ulm, Germany. christoph.spraul@medizin.uni-ulm.de
9.4.8 Glaucomas associated with intraocular tumors (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)