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Iris melanoma
Last reviewed: 07.07.2025
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Iris melanoma develops at the age of 9 to 84 years, more often in the fifth decade of life in women. In half of the patients, the duration of the disease before contacting a doctor is about 1 year, in the rest, a dark spot on the iris is noticed in childhood. Iris melanoma is morphologically characterized by pronounced structural and cellular atypism. The spindle cell type of tumor is mainly observed, which determines its more benign course.
[ Symptoms of Iris Melanoma
According to the growth pattern, there are nodular, diffuse (extremely rare) and mixed melanomas of the iris. Nodular melanoma of the iris has the appearance of an ill-defined node protruding into the anterior chamber. The surface of the tumor is uneven, the depth of the anterior chamber is uneven. The color of the melanoma varies from light to dark brown. Growing into the stroma of the iris, the tumor can imitate a cyst. When the melanoma comes into contact with the posterior epithelium of the cornea, its local opacity occurs. Growing through the dilator of the iris, the tumor leads to a change in the shape of the pupil: its edge on the side of the tumor flattens, does not respond to mydriatics. In the corner of the anterior chamber, there is congestion in the vessels of the iris. The tumor can fill the posterior chamber, causing compression of the lens, its opacity and posterior dislocation. Tumor cell complexes are scattered across the surface of the iris, and it takes on a mottled appearance. As a result of the tumor growing into the angle of the anterior chamber, the outflow of intraocular fluid is disrupted, and persistent intraocular hypertension develops that is not amenable to drug therapy.
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Treatment of iris melanoma
Treatment of iris melanoma is surgical. Localized iris melanoma, occupying no more than 1/3 of itscircumference, is subject to local removal. Local photodynamic therapy is possible. In case of a larger lesion, enucleation of the eyeball should be recommended. The prognosis for life is usually favorable, given the prevalence of the spindle cell type of tumor. Metastasis of iris melanoma is observed in 5-15% of cases and mainly with large tumors. The prognosis for vision after organ-preserving operations for iris melanoma is usually favorable.
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