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Iris Melanocytoma in a Child: Clinical and Histopathological Findings

Challenging differential diagnosis, Rare disease, Rare coexistence of disease or pathology

Abdulkarim Al-Kharashi, Wael A. Alsakran, Abdulaziz A. Alshamrani, Abdulrahman AlZaid, Azza M.Y. Maktabi, Yahya A. Alzahrani

Saudi Arabia King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia

Am J Case Rep 2021; 22:e931385

DOI: 10.12659/AJCR.931385

Available online: 2021-05-18

Published: 2021-06-21


#931385

BACKGROUND: Melanocytoma is rare and can affect any part of the uveal tract. In rare cases, iris melanocytoma shows signs of growth, with extrascleral extension that mimics melanoma. This phenomenon makes clinical differentiation between the 2 pathologies particularly challenging.
CASE REPORT: A 3-year-old boy presented with recurrent ocular inflammation. Examination revealed a large, solid, homogenous mass in the inferior quadrants of the iris, with secondary localized corneal edema. The lesion did not extend to the ciliary body and fundus examination showed no lesions in the posterior segment, including the head of the optic nerve. The patient underwent a sectoral iridocyclectomy and excisional biopsy of the lesion in the iris. Histopathology of the lesion confirmed the diagnosis of iris melanocytoma.
CONCLUSIONS: The differential diagnosis for a mass in the iris is broad, ranging from benign cysts to melanoma, which is a life-threatening ocular condition. An iris melanocytoma always should be considered in the differential of these masses, despite their exceedingly low incidence. Although iris melanocytoma mainly manifests in patients who are middle-aged or older, it should be suspected in young children, as underscored by the present report.

Keywords: Iris, Iris Diseases, Iris Neoplasms



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