Cargando…

A Case of Iris Melanocytoma Demonstrating Diffuse Melanocytic Proliferation with Uncontrolled Intraocular Pressure

We report a rare case with histologically proven melanocytoma of the iris that demonstrated diffuse melanocytic proliferation with uncontrolled secondary glaucoma and investigate the etiology of the intraocular pressure elevation. The patient was a 78-year-old man with a history of darkened iris of...

Descripción completa

Detalles Bibliográficos
Autores principales: Kusunose, Mami, Sakino, Yuji, Noda, Yoshihiro, Daa, Tsutomu, Kubota, Toshiaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422834/
https://www.ncbi.nlm.nih.gov/pubmed/28512420
http://dx.doi.org/10.1159/000464349
_version_ 1783234843206746112
author Kusunose, Mami
Sakino, Yuji
Noda, Yoshihiro
Daa, Tsutomu
Kubota, Toshiaki
author_facet Kusunose, Mami
Sakino, Yuji
Noda, Yoshihiro
Daa, Tsutomu
Kubota, Toshiaki
author_sort Kusunose, Mami
collection PubMed
description We report a rare case with histologically proven melanocytoma of the iris that demonstrated diffuse melanocytic proliferation with uncontrolled secondary glaucoma and investigate the etiology of the intraocular pressure elevation. The patient was a 78-year-old man with a history of darkened iris of his left eye. The intraocular pressure was 39 mm Hg. A slit-lamp examination showed a diffuse darkened iris, and a gonioscopic examination revealed open angle with circumferential heavy pigmentation. There was no pigment dispersion of the anterior chamber and no pigment deposition of the cornea. We suspected malignant ring melanoma in the left eye and enucleated it. The globe was examined with light and electron microscopy. Light microscopy revealed the presence of heavily pigmented tumor cells in the iris, ciliary body, trabecular meshwork, and Schlemm's canal. A bleached preparation showed large tumor cells with central and paracentral nuclei without mitosis. Electron microscopy of the trabecular meshwork revealed melanin-bearing tumor cells invading the intertrabecular spaces, and the melanin granules were not phagocytosed in the trabecular cells. The mechanical obstruction of the aqueous flow by the tumor cells may be a major cause of secondary glaucoma in eyes with iris melanocytoma presenting diffuse proliferation.
format Online
Article
Text
id pubmed-5422834
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher S. Karger AG
record_format MEDLINE/PubMed
spelling pubmed-54228342017-05-16 A Case of Iris Melanocytoma Demonstrating Diffuse Melanocytic Proliferation with Uncontrolled Intraocular Pressure Kusunose, Mami Sakino, Yuji Noda, Yoshihiro Daa, Tsutomu Kubota, Toshiaki Case Rep Ophthalmol Case Report We report a rare case with histologically proven melanocytoma of the iris that demonstrated diffuse melanocytic proliferation with uncontrolled secondary glaucoma and investigate the etiology of the intraocular pressure elevation. The patient was a 78-year-old man with a history of darkened iris of his left eye. The intraocular pressure was 39 mm Hg. A slit-lamp examination showed a diffuse darkened iris, and a gonioscopic examination revealed open angle with circumferential heavy pigmentation. There was no pigment dispersion of the anterior chamber and no pigment deposition of the cornea. We suspected malignant ring melanoma in the left eye and enucleated it. The globe was examined with light and electron microscopy. Light microscopy revealed the presence of heavily pigmented tumor cells in the iris, ciliary body, trabecular meshwork, and Schlemm's canal. A bleached preparation showed large tumor cells with central and paracentral nuclei without mitosis. Electron microscopy of the trabecular meshwork revealed melanin-bearing tumor cells invading the intertrabecular spaces, and the melanin granules were not phagocytosed in the trabecular cells. The mechanical obstruction of the aqueous flow by the tumor cells may be a major cause of secondary glaucoma in eyes with iris melanocytoma presenting diffuse proliferation. S. Karger AG 2017-03-30 /pmc/articles/PMC5422834/ /pubmed/28512420 http://dx.doi.org/10.1159/000464349 Text en Copyright © 2017 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Case Report
Kusunose, Mami
Sakino, Yuji
Noda, Yoshihiro
Daa, Tsutomu
Kubota, Toshiaki
A Case of Iris Melanocytoma Demonstrating Diffuse Melanocytic Proliferation with Uncontrolled Intraocular Pressure
title A Case of Iris Melanocytoma Demonstrating Diffuse Melanocytic Proliferation with Uncontrolled Intraocular Pressure
title_full A Case of Iris Melanocytoma Demonstrating Diffuse Melanocytic Proliferation with Uncontrolled Intraocular Pressure
title_fullStr A Case of Iris Melanocytoma Demonstrating Diffuse Melanocytic Proliferation with Uncontrolled Intraocular Pressure
title_full_unstemmed A Case of Iris Melanocytoma Demonstrating Diffuse Melanocytic Proliferation with Uncontrolled Intraocular Pressure
title_short A Case of Iris Melanocytoma Demonstrating Diffuse Melanocytic Proliferation with Uncontrolled Intraocular Pressure
title_sort case of iris melanocytoma demonstrating diffuse melanocytic proliferation with uncontrolled intraocular pressure
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422834/
https://www.ncbi.nlm.nih.gov/pubmed/28512420
http://dx.doi.org/10.1159/000464349
work_keys_str_mv AT kusunosemami acaseofirismelanocytomademonstratingdiffusemelanocyticproliferationwithuncontrolledintraocularpressure
AT sakinoyuji acaseofirismelanocytomademonstratingdiffusemelanocyticproliferationwithuncontrolledintraocularpressure
AT nodayoshihiro acaseofirismelanocytomademonstratingdiffusemelanocyticproliferationwithuncontrolledintraocularpressure
AT daatsutomu acaseofirismelanocytomademonstratingdiffusemelanocyticproliferationwithuncontrolledintraocularpressure
AT kubotatoshiaki acaseofirismelanocytomademonstratingdiffusemelanocyticproliferationwithuncontrolledintraocularpressure
AT kusunosemami caseofirismelanocytomademonstratingdiffusemelanocyticproliferationwithuncontrolledintraocularpressure
AT sakinoyuji caseofirismelanocytomademonstratingdiffusemelanocyticproliferationwithuncontrolledintraocularpressure
AT nodayoshihiro caseofirismelanocytomademonstratingdiffusemelanocyticproliferationwithuncontrolledintraocularpressure
AT daatsutomu caseofirismelanocytomademonstratingdiffusemelanocyticproliferationwithuncontrolledintraocularpressure
AT kubotatoshiaki caseofirismelanocytomademonstratingdiffusemelanocyticproliferationwithuncontrolledintraocularpressure