Photo Essay

Pigment Epithelium Macroadenoma Mimicking Iris or
Ciliary Body Melanoma

Sara Sánchez-Tabernero, MD1; Ciro García-Alvarez, PhD2; Elena García-Lagarto, MD3; Maria A Saornil2, PhD

1Department of Ophthalmology, Anterior Segment Service, Moorfields Eye Hospital, London, UK
2Servicio de Oftalmología, Unidad de Tumores Intraoculares del Adulto, Hospital Clínico Universitario de Valladolid, Spain

3Unidad de Patología, Hospial Clínico Universitario de Valladolid, Spain

ORCID:
Sara Sánchez-Tabernero: http://orcid.org/0000-0003-1745-2890

J Ophthalmic Vis Res 2021; 16 (2): 306–307

PRESENTATION

A 66-year-old man presented to the Intraocular
Tumor Unit at Hospital Clínico Universitario of
Valladolid, Spain, with a one-year history of
gradual vision loss in the left eye. The patient
had previously undergone cataract surgery.
Examination revealed a mass arising from the iris,
invading the iridocorneal angle and ciliary body,
and displacing the intraocular lens posteriorly.
The dimensions were 11.51 × 11.39 × 7.53 mm, as
measured under ultrasound biomicroscopy. The
mass was hyperintense on T1- and hypointense
on T2-weighed magnetic resonance images.
This is the most frequent pattern described in
ciliary pigment epithelium adenomas, although
hyperintensity on both T1- and T2-weighted
images has also been reported.[1] Enucleation was
performed because of suspected iris melanoma.
Histopathology demonstrated nests and cords of
pigmented epithelial cells with an adenoid pattern,
consistent with previous studies.[1, 2] Atypia, mitotic
figures, or infiltrative features were not observed.

Correspondence to:

Sara Sánchez-Tabernero, MD. Department of
Ophthalmology, Anterior Segment Service, Moorfields
Eye Hospital, 51 North Block, SE1 7PJ London, UK.
Email: s.t.sara.g@gmail.com
Received: 08-04-2020 Accepted: 28-09-2020

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Website: https://knepublishing.com/index.php/JOVR

DOI: 10.18502/jovr.v16i2.9100

Histopathology was diagnostic of macroadenoma
of iris pigment epithelium, although a ciliary body
origin could not be excluded.

DISCUSSION

Histopathology demonstrated nests and cords
of pigmented epithelial cells with an adenoid
pattern, consistent with previous studies.[1, 2]
Atypia, mitotic figures, or infiltrative features were
not observed.

Histopathology was diagnostic of
macroadenoma of iris pigment epithelium,
although a ciliary body origin could not be
excluded.

Financial Support and Sponsorship

Nil.

Conflicts of Interest

The authors declare no interests.

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How to cite this article: Sánchez-Tabernero S, García-Alvarez C, García-
Lagarto E, Saornil MA. Pigment Epithelium Macroadenoma Mimicking Iris
or Ciliary Body Melanoma. J Ophthalmic Vis Res 2021;16:306–307.

306 © 2021 SÁNCHEZ-TABERNERO ET AL. THIS IS AN OPEN ACCESS ARTICLE DISTRIBUTED UNDER THE CREATIVE COMMONS ATTRIBUTION LICENSE |
PUBLISHED BY KNOWLEDGE E

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Photo Essay; Sánchez-Tabernero et al

A B C

D E F

Figure 1. (A) Slit-lamp biomicroscopy showing an iris mass. (B) Ultrasound biomicroscopy. (C) Mass on T1- and T2-weighed magnetic
resonance images. (D) Enucleated eye. (E&F) Hematoxylin and eosin stain, 4× and low-power magnification.

REFERENCES

1. Chang Y, Wei WB, Shi JT, Xian JF, Yang WL, Xu XL,
et al. Clinical and histopathological features of adenomas

of the ciliary pigment epithelium. Acta Ophthalmol
2016;94:e637–e643.

2. Shields JA, Shields CL, Mercado G, Gündüz K, Eagle RC.
Adenoma of the iris pigment epithelium: a report of 20
cases. Arch Ophthalmol 1999;117:736–741.

JOURNAL OF OPHTHALMIC AND VISION RESEARCH VOLUME 16, ISSUE 2, APRIL-JUNE 2021 307