Ocular Oncology Service, Suite 1440, Wills Eye Institute, 840 Walnut Street, Philadelphia, PA 19107, USA.
Ophthalmology. 2012 Feb;119(2):407-14. doi: 10.1016/j.ophtha.2011.07.059. Epub 2011 Oct 27.
To report the spectrum of iris lesions based on patient age at presentation.
Retrospective, nonrandomized, single-center case series.
We included 3680 iris tumors in 3451 patients.
Chart review.
Diagnostic category based on age.
The mean age at presentation was 48 years and there were 449 (12%) tumors in children (≤20 years), 788 (21%) in young adults (21-40 years), 1308 (36%) in mid adults (41-60 years), and 1135 (31%) in senior adults (>60 years). Of 3680 tumors, the diagnostic category was cystic (n = 768; 21%) or solid (n = 2912; 79%). The cystic tumors originated from iris pigment epithelium (IPE; n = 672; 18%) or iris stroma (n = 96; 3%). The solid tumors included melanocytic (n = 2510; 68%) and nonmelanocytic (n = 402; 11%). The melanocytic tumors comprised nevus (n = 1503; 60%), melanocytoma (n = 68; 3%), melanoma (n = 645; 26%), and melanocytosis (n = 64; 3%). Of 2510 melanocytic tumors, the first and second most common diagnoses by age (children, young adult, mid adult, senior adult) were nevus (53%, 57%, 63%, and 63%, respectively) and melanoma (17%, 27%, 26%, and 27%, respectively). The nonmelanocytic tumors included categories of choristomatous (n = 4; <1%), vascular (n = 57; 2%), fibrous (n = 2; <1%), neural (n = 3; <1%), myogenic (n = 2;, <1%), epithelial (n = 35; 1%), xanthomatous (n = 8; <1%), metastasis (n = 67; 2%), lymphoid (n = 12; <1%), leukemic (n = 2; <1%), secondary (n = 12; <1%), and nonneoplastic simulators (n = 198; 5%). The median age (in years) at diagnosis included cystic (39), melanocytic (52), choristomatous (0.7), vascular (56), fibrous (53), neural (8), myogenic (42), epithelial (63), xanthomatous (1.9), metastasis (60), lymphoid (57), leukemic (25.5), secondary (59), and nonneoplastic simulators (49). Overall, the 3 most common specific diagnoses (children, young adult, mid adult, senior adult) were nevus (25%, 36%, 47%, and 47%, respectively), IPE cyst (28%, 30%, 15%, and 14%, respectively), and melanoma (8%, 16%, 20%, and 19%, respectively).
In an ocular oncology practice, the spectrum of iris tumors includes cystic (21%) and solid (79%) tumors. The solid tumors were melanocytic (68%) or nonmelanocytic (11%). At all ages, the most common specific diagnoses were nevus (42%), IPE cyst (19%), and melanoma (17%).
根据患者就诊时的年龄报告虹膜病变谱。
回顾性、非随机、单中心病例系列。
我们纳入了 3451 名患者的 3680 个虹膜肿瘤。
病历回顾。
基于年龄的诊断类别。
就诊时的平均年龄为 48 岁，其中有 449（12%）个肿瘤发生于儿童（≤20 岁），788（21%）个肿瘤发生于青年（21-40 岁），1308（36%）个肿瘤发生于中年（41-60 岁），1135（31%）个肿瘤发生于老年（>60 岁）。在 3680 个肿瘤中，诊断类别为囊性（n=768；21%）或实性（n=2912；79%）。囊性肿瘤来源于虹膜色素上皮（IPE；n=672；18%）或虹膜基质（n=96；3%）。实性肿瘤包括黑色素瘤（n=2510；68%）和非黑色素瘤（n=402；11%）。黑色素瘤肿瘤包括痣（n=1503；60%）、黑色素细胞瘤（n=68；3%）、黑色素瘤（n=645；26%）和黑色素增多症（n=64；3%）。在 2510 个黑色素瘤中，按年龄（儿童、青年、中年、老年）划分的前两个最常见诊断是痣（53%、57%、63%和 63%）和黑色素瘤（17%、27%、26%和 27%）。非黑色素瘤肿瘤包括类瘤（n=4；<1%）、血管（n=57；2%）、纤维（n=2；<1%）、神经（n=3；<1%）、肌源性（n=2；<1%）、上皮（n=35；1%）、黄瘤（n=8；<1%）、转移瘤（n=67；2%）、淋巴样（n=12；<1%）、白血病（n=2；<1%）、继发性（n=12；<1%）和非肿瘤性模拟物（n=198；5%）。诊断时的中位年龄（岁）包括囊性（39）、黑色素瘤（52）、类瘤（0.7）、血管（56）、纤维（53）、神经（8）、肌源性（42）、上皮（63）、黄瘤（1.9）、转移瘤（60）、淋巴样（57）、白血病（25.5）、继发性（59）和非肿瘤性模拟物（49）。总体而言，3 种最常见的特定诊断（儿童、青年、中年、老年）分别是痣（25%、36%、47%和 47%）、IPE 囊肿（28%、30%、15%和 14%）和黑色素瘤（8%、16%、20%和 19%）。
在眼肿瘤科实践中，虹膜肿瘤的范围包括囊性（21%）和实性（79%）肿瘤。实性肿瘤为黑色素瘤（68%）或非黑色素瘤（11%）。在所有年龄段，最常见的特定诊断是痣（42%）、IPE 囊肿（19%）和黑色素瘤（17%）。
