Spontaneous Regression of Iris Melanocytoma: A Case Report

Introduction

A melanocytoma is a rare, darkly pigmented nevus subtype, also called “magnocellular” nevus, as it consists of large and uniform polygonal cells with small nuclei and an intensely pigmented cytoplasm.

It was first described by Zimmerman in 1962 at the level of the optic disc [1], and was subsequently identified within the iridociliary complex. The choroid, sclera, or conjunctiva are exceptional locations [2].

Iridociliary melanocytomas are benign tumors, whose evolution can be marked by slow and limited growth (23% after 5 years) [3], which can be difficult to differentiate clinically from malignant transformation (lifetime risk: 2 – 5%) [3], [4], [5]. Spontaneous necrosis with secondary pigment dispersion glaucoma is a frequent complication (11 – 30%) [2], [3], but to our knowledge, a nearly complete and spontaneous regression has never been reported.

• References

• 1 Zimmerman LE, Garron LK. Melanocytoma of the optic disc. Int Ophthalmol Clin 1962; 2: 431-440
• 2 Zografos L, Uffer S. Tumeurs iriennes pigmentées. In: Zografos L. ed. Tumeurs intraoculaires. Paris: Masson; 2002: 281-319
• 3 Demirci H, Mashayekhi A, Shields CL. et al. Iris melanocytoma: clinical features and natural course in 47 cases. Am J Ophthalmol 2005; 139: 468-475
• 4 Zografos L, Othenin-Girard CB, Desjardins L. et al. Melanocytomas of the optic disk. Am J Ophthalmol 2004; 138: 964-969
• 5 Inoue R, Saishin Y, Shima C. et al. A case of iris melanocytoma transformed to malignant melanoma. Jpn J Ophthalmol 2009; 53: 271-273
• 6 Teichmann KD, Karcioglu ZA. Melanocytoma of the iris with rapidly developing secondary glaucoma. Surv Ophthalmol 1995; 40: 136-144
• 7 Fineman MS, Eagle RC, Shields JA. et al. Melanocytomalytic glaucoma in eyes with necrotic iris melanocytoma. Ophthalmology 1998; 105: 492-496