Geisse L J, Robertson D M
Am J Ophthalmol. 1985 Jun 15;99(6):638-48. doi: 10.1016/s0002-9394(14)76028-3.
Most iris tumors behave benignly, reflecting their small size and the high proportion of nevi and spindle A melanomas. Of 1,043 reported iris melanomas, 31 metastasized (3%). Metastasis from a spindle A melanoma is not known to occur despite documented growth and local recurrence after excision. If known spindle A melanomas are excluded from all reported spindle cell tumors of the iris, the rate of metastasis for spindle cell tumors is 2.6%. Mixed-cell melanomas have a metastasis rate of 10.5% and epithelioid melanomas a rate of 6.9%. The interval between the histologic diagnosis and death from metastases ranged from three months to 12 years, with an average of 6.5 years. Five- and ten-year mortality rates for different cell types cannot be ascertained. Iris angiography may be useful in defining the limits of tumor involvement but is of uncertain value in differentiating benignancy from malignancy. Of the 31 cases with metastases, 21 included information on the type of surgical procedure used to obtain the histologic diagnosis. In 13 of the 21 cases (62%), the tumors were initially involved with either incomplete excision or inadvertent transection before enucleation.
大多数虹膜肿瘤表现为良性，这反映了它们的体积较小以及痣和梭形A黑素瘤所占比例较高。在报告的1043例虹膜黑素瘤中，31例发生转移（3%）。尽管有记录显示梭形A黑素瘤切除后有生长和局部复发，但尚未发现其发生转移。如果将已知的梭形A黑素瘤从所有报告的虹膜梭形细胞瘤中排除，梭形细胞瘤的转移率为2.6%。混合细胞型黑素瘤的转移率为10.5%，上皮样黑素瘤的转移率为6.9%。从组织学诊断到因转移死亡的间隔时间为3个月至12年，平均为6.5年。不同细胞类型的5年和10年死亡率无法确定。虹膜血管造影可能有助于确定肿瘤累及的范围，但在区分良性和恶性方面价值不确定。在31例发生转移的病例中，21例包含了用于获取组织学诊断的手术方法类型的信息。在这21例病例中的13例（62%）中，肿瘤最初在眼球摘除术前涉及不完全切除或意外横断。
