Are most iris "melanomas' really nevi? A clinicopathologic study of 189 lesions
F. A. Jakobiec and G. Silbert
A retrospective clinicopathologic study of 189 iris and iris and ciliary
body lesions originally diagnosed as melanomas led to a nine-part
histopathologic classification. Eighty-seven percent of lesions were
reassigned to six benign categories and 13% were assigned to three
malignant ones (spindle-B and epithelioid cell melanomas). There were no
tumor deaths. The benign lesions were so classified if the constituent
cells displayed bland cytologic characteristics, even though they might
have produced a surface plaque or growth onto the trabecular meshwork and
peripheral cornea. No clinical features were found to distinguish the
benign from malignant tumors, including diffuse spread and the presence of
glaucoma. The six recurrent tumors were equally divided between benign and
malignant lesions. Thirty-six of 42 patients with incompletely excised
lesions did not show further clinical problems on follow-up, establishing
the inherently benign nature of most of the tumors.
