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Ophthalmic Images
May 9, 2019

Iris Metastasis

Author Affiliations
  • 1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
JAMA Ophthalmol. 2019;137(5):e185029. doi:10.1001/jamaophthalmol.2018.5029

A 54-year-old man complained of blurred vision in his left eye. His medical history was unremarkable. His visual acuity was 20/40 OS. Slitlamp examination results revealed a fan-shaped mass on the inferior iris surface. Feeding vessels were abundant (Figure, A). Ultrasonography biomicroscopy results demonstrated the neoplasm originating from the iris. Dense hyperechoic spots were noted within the mass (Figure, B). He refused to undergo intraocular biopsy or systemic workup as we suggested. One month later, he was admitted for enucleation due to massive hyphema and refractory glaucoma. A diagnosis of iris metastasis was established by histopathology while the primary tumor was undetermined. Two months later, he died of brain metastasis. Metastatic tumors in the iris are rare, but they may be the first sign of systemic diseases.1 The sites of the primary carcinomas are most frequently the lung or breast.2 The prognosis typically is poor, with most patients surviving less than 10 months.3

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