[IRIS NEOPLASMS AND THEIR SURGICAL TREATMENT].
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A 66-year-old man had decreased visual acuity in the left eye. Slit-lamp examination showed hyperpigmentation of the periphery of the iris from 2:30 to 9 o'clock. Gonioscopy disclosed an ill-defined mass involving the angle and extending from 5 to 7:30 o'clock with diffuse pigmentation of the meshwork for 360 degrees. A sector iridectomy was performed inferiorly in his left eye. Histopathologic examination disclosed a diffuse malignant melanoma of the iris, mixed cell type. The patient was free of recurrence when examined at 18, 24 and 30 months following surgery. Two years and ten months following the iridectomy, the patient developed multiple metastatic bony lesions and a mass in the liver. Bone marrow aspiration from the sternum and biopsy from the iliac crest, respectively, showed metastatic malignant melanoma. He died shortly thereafter and an autopsy was not performed. The remote possibility of an occult, intraocular tumor such as a ciliary body melanoma or an internally located melanoma cannot be excluded. Assuming that this is indeed an iris melanoma, as our studies indicate, the rarity of this metastatic iris neoplasm is emphasized by noting that only 37 cases of iris melanomas with presumed metastases have been reported in the literature.
A six-year-old intact male Pomeranian was examined because of right eye discomfort. An iris neoplasm was suspected and the eye was enucleated. A uveal melanoma with malignant features was diagnosed. The dog recovered uneventfully from surgery. A general physical examination was performed at 3-month intervals afterwards without any detectable problem, but 18 months after the first presentation the dog suffered a rapid, progressive paraplegia. Radiographic examination and myelography revealed a spinal cord compression at the level of the 8th thoracic (T8) vertebral body. Surgical exploration of the area revealed a potential vertebral neoplasm: histopathology confirmed a melanoma which was suspected to have resulted from metastasis from the previously diagnosed uveal melanoma.
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We treated a 40-year-old man with an acute, unilateral, open-angle glaucoma caused by a gelatinous translucent material in the anterior chamber. A clinical diagnosis of mucogenic secondary open-angle glaucoma caused by diffuse epithelial ingrowth after ocular trauma one year earlier was suspected, but a primary or secondary ciliary body or iris neoplasm could not be ruled out. A curative 9-mm block-excision was performed. Six years later, intraocular pressure was normal, and the visual function was unchanged. Light and electron microscopy disclosed an island of diffuse columnar epithelium with numerous goblet cells on the iris surface and copious mucinous material extending into the trabecular mesh-work.
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