Background: We present an atypical case of recurrent iris melanocytoma in a young African-American girl. She initially presented with aggressive pigmentary glaucoma along with significant anterior ocular inflammation that resolved with excision of the lesion in conjunction with medical management. Six months after the documentation of a normotensive, quiet eye, the patient returned with a recurrent pigmentary glaucoma and a novel pigmented iris lesion. The associated findings made this case of iris melanocytoma quite unusual. Methods: Following diagnosis by fine needle aspiration of the iris lesion, a sectoral iridectomy was performed to excise the lesion. Pathologic studies included cytologic and histologic analyses. Upon recurrence, the neoplasm and adjacent iris were excised with a combination of irrigation, aspiration, and vitrectomy cutter. Results: The patient's initial course resolved with excision of the lesion and treatment with both topical and systemic steroids. The recurrent glaucoma resolved after excision and an anterior chamber washout procedure. Topical anti-glaucoma agents were used during both bouts to help control intraocular pressure. All pathologic specimens were consistent with melanocytoma. Final visual acuity was 6/7.5 Conclusions: This case represents an unusual presentation of iris melanocytoma - the location of the melanocytoma, recurrence, and the significant inflammatory component on presentation are atypical. The case demonstrates that the diagnosis of melanocytoma should not be excluded in young children or in African-Americans, and the condition may be successfully treated with topical and systemic steroids as well as antiglaucoma agents, while management decisions are contemplated.
|Original language||English (US)|
|Number of pages||4|
|Journal||Clinical and Surgical Ophthalmology|
|State||Published - Nov 2004|
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