PMC10220440_01
Clinical photograph of the left eye showing localized pink globular mass with vascularization on iris at 4 o'clock with few nodules on the surface of iris denoted by white arrow head
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F1
Single localized pink globular mass with vascularization arising from the iris at 4 o'clock that appeared to extend behind onto posterior chamber was identified [Figure 1].
(a-c) Ultrasound biomicroscopy showing a large heterogenous mass lesion involving ciliary body with pockets of intralesional cyst, involving anterior chamber, angle, and iris with pupillary membrane denoted by black arrow heads
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F2
UBM revealed a large heterogenous mass lesion involving ciliary body with pockets of intralesional cyst, involving AC, angle, and iris with pupillary membrane [Figure 2a-c].
(a-d) Histopathological examination with hematoxylin and eosin staining of the mass lesion obtained from surgical excision. (a) A x10 magnification demonstrates fragments of pigmented tissue of ciliary body and sclera with minimal hyperplasia of ciliary muscles and pigment epithelium. (b) Touton giant cells (black arrow) with histiocytic infiltration of the iris stroma (x10). (c) A x40 magnification demonstrates diffuse infiltration of chronic inflammatory cells and xanthomatous histiocytes. (d) Showing stromal infiltration of mixed inflammatory cells eosinophils, histiocytes with spindling (black arrow), and interspersed lymphocytes (x40)
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F3
HPE as shown in Figure 3a-d demonstrated stromal infiltration of eosinophils, histiocytes [Figure 3d black arrow], scattered lymphocytes, mixed inflammatory cellular infiltrate denoting Touton giant cells [Figure 3b black arrow], and well-defined granuloma with multinucleated cells which were confirmatory of JXG.
(a-c) Postoperative images. (a) Clinical photograph of the left eye showing healed corneal surgical scar inferiorly, iridectomy, and aphakia. (b) Postoperative fundus picture showing a normal optic disc, macula, and a fibrovascular retinal fold extending anteriorly away from the disc with attached retina. (c) Postoperative ultrasound biomicroscopy showing surgically resolved juvenile xanthogranuloma with no recurrence of lesion
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F4
Fundus showed a normal-appearing disc, retinal fibrovascular fold extending anteriorly away from the disc and rest of the retina appeared attached, and UBM showed postsurgical complete resolution of the lesion [Figure 4a-c postoperative images].