PMC6489088_01
A slit-lamp photograph of the right eye. a A slit-lamp photograph of the right eye shows that the mass emerged at the 11 o'clock position at the first visit. The mass grew slightly 7 months (b) and 21 months later (c). d An iris mass was observed on anterior segment optical coherent tomography (AS-OCT). The anterior part of the mass appeared slightly reflective (d, e) and changed to hyporeflective (f). g During the observation, the mass rapidly increased in size 24 months later. h Iridocyclectomy was performed. i One year later, cataract surgery was performed with no complication and no recurrence. j Due to poor visibility of the posterior surface of the iris, shadowing was observed on AS-OCT. k After surgery, the iris periphery could not be observed due to the surgery.
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F1
Slit-lamp examination of the right eye revealed an amelanotic white nodule with a regular surface that originated from the iris root (Fig. 1a). Nagoya, Japan) showed that the mass originated from the iris root and extended to the ciliary body (Fig. 1d). The left eye was normal. N-isopropyl-(123I)-p-iodoamphetamine ((123I)-IMP) single-photon emission computed tomography (123I-IMP SPECT) revealed no abnormal accumulation. Clinical findings indicated that the tumor was most likely not a malignant melanoma, resulting in a course of periodic observation (Fig. 1b, c, e, f). The mass appeared to be growing and indenting the lens, resulting in the irregular surface (Fig. 1g, j). Ultimately, iridocyclectomy was successfully performed under general anesthesia (Fig. 1h). The BCVA of the right eye decreased to 0.07 and cataract surgery was performed (Fig. 1i). During 1 year of follow-up after iridocyclectomy and cataract surgery, no sign of tumor recurrence was seen (Fig. 1k).
Histopathology of the resected specimen inside and outside of the ciliary epithelium. a, b Histopathology of the resected specimen inside of the ciliary epithelium showed solid components. a A strong positive immunoreaction to cytokeratin AE1/AE3 can be seen (yellow arrows) inside of the ciliary epithelium. Original magnification, x40. b The solid components were composed of round cells and short spindle-shaped cells stained with hematoxylin and eosin. Original magnification, x200. c, d Histopathology of the resected specimen outside of the iris showed tubular components. c The proliferation index using MIB-1 staining was 8%. Original magnification, x100. d CD68 immunostaining was negative. Original magnification, x100.
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F2
The solid components were inside of the ciliary epithelium (Fig. 2a, b), and the tubular components were outside (Fig. 2c, d). A positive reaction to vimentin and cytokeratin CK (AE1/AE3) was observed (Fig. 2a), while negative reactions to S-100 and CD68 were found in the tissue (Fig. 2d). The MIB-1 index was 8% (Fig. 2c).