Pigment Epithelium Macroadenoma Mimicking Iris or Ciliary Body Melanoma.

PRESENTATION

A 66-year-old man presented to the Intraocular Tumor Unit at Hospital Clínico Universitario of Valladolid, Spain, with a one-year history of gradual vision loss in the left eye. The patient had previously undergone cataract surgery. Examination revealed a mass arising from the iris, invading the iridocorneal angle and ciliary body, and displacing the intraocular lens posteriorly. The dimensions were 11.51 11.39 7.53 mm, as measured under ultrasound biomicroscopy. The mass was hyperintense on T1- and hypointense on T2-weighed magnetic resonance images. This is the most frequent pattern described in ciliary pigment epithelium adenomas, although hyperintensity on both T1- and T2-weighted images has also been reported.[ Enucleation was performed because of suspected iris melanoma. Histopathology demonstrated nests and cords of pigmented epithelial cells with an adenoid pattern, consistent with previous studies.[ Atypia, mitotic figures, or infiltrative features were not observed. Histopathology was diagnostic of macroadenoma of iris pigment epithelium, although a ciliary body origin could not be excluded.

(A) Slit-lamp biomicroscopy showing an iris mass. (B) Ultrasound biomicroscopy. (C) Mass on T1- and T2-weighed magnetic resonance images. (D) Enucleated eye. (E&F) Hematoxylin and eosin stain, 4 and low-power magnification.

DISCUSSION

Histopathology demonstrated nests and cords of pigmented epithelial cells with an adenoid pattern, consistent with previous studies.[ Atypia, mitotic figures, or infiltrative features were not observed.

Histopathology was diagnostic of macroadenoma of iris pigment epithelium, although a ciliary body origin could not be excluded.

Financial Support and Sponsorship

Nil.

Conflicts of Interest

The authors declare no interests.