Iris Melanoma Outcomes Based on the American Joint Committee on Cancer Classification (Eighth Edition) in 432 Patients

Shields, Carol L.; Nicola, Maura Di; Bekerman, Vladislav P; Kaliki, Swathi; Alarcón, Carolina; Fulco, Enzo; Shields, Jerry A.

doi:10.1016/j.ophtha.2017.11.040

Cited by 30 publications

(21 citation statements)

References 12 publications

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“…16 Several retrospective series have analyzed the incidence of local recurrence after iris melanoma. 4 , 5 , 10 , 13 , 17 , 18 , 19 , 20 Findings from the three most recent studies are detailed below. Noticeably, the reported low rate of local relapse may be underestimated in the literature because studies do not typically span between 15 and 20 years after the initial treatment.…”

Section: Discussionmentioning

confidence: 99%

“… 9 Systemic monitoring for metastases is performed by iterative liver ultrasonography. According to literature reports, 5 , 10 the estimated rate of metastases is ∼3–5% and ∼5–10% at 5-year and 10-year, respectively. Mortality related to iris melanoma is estimated at ∼3% and ∼4%, 5 and 10 years after diagnosis, respectively.…”

Section: Introductionmentioning

confidence: 97%

“…2 Iris melanomas can be melanotic (∼80%), amelanotic (∼20%) or mixed (<1%). 5 Imaging with ultrasound biomicroscopy is required to assess tumor dimensions and extension to structures posterior to the iris, such as the ciliary body. 6 , 7 It also identifies features suggestive of malignancy such as irregular internal reflectivity of the tumor, extension through the iris pigmented epithelium, and presence of intralesional cystic areas 8 corresponding to the histopathological findings.…”

Section: Introductionmentioning

confidence: 99%

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Iris melanoma relapsing sixteen years after proton-beam therapy: The importance of lifelong follow-up

Msika

Desjardins

Cockenpot

et al. 2019

American Journal of Ophthalmology Case Reports

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PurposeTo report a case of locally recurrent spindle-cell iris amelanotic melanoma 16 years after proton-beam therapy.ObservationsIn 2001, a 45-year-old man presented with an amelanotic iris melanoma, extending from the 5 to 10 o'clock positions on his left eye. High-frequency ultrasonography showed extension of melanoma into the ciliary body. He was initially managed with proton-beam therapy (60 Gy delivered in four fractions over four consecutive days) and underwent ocular and systemic examination at regular intervals over the following years. Local tumor control was achieved, and the patient did not develop metastasis during sixteen consecutive years. In 2017, 16 years after he received proton-beam therapy, the patient developed a focal amelanotic lesion strongly suggestive of a local recurrence of iris melanoma, although it extended from the 1 to 6 o'clock positions. He also presented with treatment-resistant glaucoma with an intraocular pressure (IOP) of 37 mmHg, despite maximal topical IOP-lowering therapy. Since a second irradiation of the anterior segment was contraindicated, the eye was enucleated. Pathological analysis confirmed the diagnosis of iris melanoma and demonstrated iridocorneal angle invasion extending from the initial site to the recurrent tumor location.Conclusions and importanceRegular ophthalmological surveillance for life with gonioscopy and high-frequency ultrasonography is recommended in patients with iris melanoma, due to the possibility of delayed local recurrence more than a decade after the initial treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Iris melanoma relapsing sixteen years after proton-beam therapy: The importance of lifelong follow-up

Msika

Desjardins

Cockenpot

et al. 2019

American Journal of Ophthalmology Case Reports

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“…Although it has several clinical variations, iris melanoma usually appears as a pigmented mass that is diagnosed in adulthood and shows slow progression. [ 11 ] However, melanoma can sometimes appear clinically amelanotic and is less commonly diagnosed in children. The case reported here is unusual, in that iris melanoma appeared as a fairly rapidly enlarging amelanotic mass in an 8-year-old child.…”

Section: Discussionmentioning

confidence: 99%

“…The tumor was classified as pT2a based on the American Joint Committee on Cancer classification (8 th edition). [ 10 11 ]…”

Section: Case Reportmentioning

confidence: 99%

Iris melanoma in a child simulating juvenile xanthogranuloma

Shields¹,

Shields²,

Lally³

et al. 2018

Middle East Afr J Ophthalmol

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An 8-year-old girl was referred for an amelanotic iris tumor believed to have enlarged slightly over 3 months, suspicious for juvenile xanthogranuloma (JXG). The affected right eye had a lightly pigmented, vascular iris mass measuring 6 mm in basal dimension and 2 mm in thickness. There were no feeder vessels, seeding, inflammatory cells, or cutaneous abnormalities. Diagnostic fine needle aspiration biopsy (FNAB) was performed, revealing spindle B melanoma cells that were immunoreactive for melanocytic markers HMB45 and Melan-A. Complete tumor resection by basal sector iridectomy was performed. Histopathology confirmed spindle B melanoma. At 14-years follow up, there has been no recurrence or metastasis and visual acuity remains 20/25. Iris melanoma can develop in children and clinically resemble nodular JXG.

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