Mora Paolo, Calzetti Giacomo, Avellis Fernando O, Tedesco Salvatore A, Carta Arturo, Gandolfi Stefano, Zografos Leonidas
Ophthalmology Unit, University Hospital of Parma, Parma, Italy.
"Jules Gonin" Eye Hospital, University of Lausanne, Lausanne, Switzerland.
Am J Ophthalmol Case Rep. 2020 Apr 8;18:100685. doi: 10.1016/j.ajoc.2020.100685. eCollection 2020 Jun.
To report, with the aid of original imaging, an unusual differential diagnosis of an iris tumor.
A 60-year-old Caucasian man visited our clinic with a large amelanotic iris mass in the left eye in the absence of concomitant extraocular inflammation or neoplastic evidence. The patient reported an ocular trauma caused by a wire 5 years prior to his visit, which resolved after a short course of antibiotic eye drops. Orbital magnetic resonance imaging with contrast enhancement was consistent with an iris tumor; ultrasound biomicroscopy indicated a semi-solid, mid-stromal iris formation continuous with the lens. Surgical inspection was performed. Surgery showed the presence of a hypermature cataract with a fine break in the anterior capsule of the lens covered by the iris surface. The liquefied cortex infiltrated the iris without diffusing into the aqueous humor.
A so-called morgagnian cataract developed, likely following a penetrating ocular wound. The progressive, slow infiltration of the iris stroma by the crystalline matrix mimicked the appearance of an amelanotic iris tumor.
借助原始影像学报告一例虹膜肿瘤的罕见鉴别诊断。
一名60岁的白种男性因左眼出现巨大无色素性虹膜肿物前来我院就诊，无眼外炎症或肿瘤证据。患者自述就诊前5年曾因铁丝导致眼部外伤，经短期抗生素眼药水治疗后痊愈。眼眶磁共振成像增强扫描结果与虹膜肿瘤相符；超声生物显微镜检查显示为与晶状体相连的半固体、基质中层虹膜结构。进行了手术检查。手术发现存在过熟期白内障，晶状体前囊有细小破裂，被虹膜表面覆盖。液化的皮质浸润虹膜但未扩散至房水。
可能因穿透性眼外伤后形成了所谓的莫尔加尼白内障。晶状体基质对虹膜基质的渐进性、缓慢浸润酷似无色素性虹膜肿瘤的表现。
