Case Study 3 Small Ciliary Body Melanoma

Abstract

NG is a 29-year-old woman who was noted on a routine eye examination to have a pigmented lesion of her left temporal iris root. The same optometrist had checked her in the prior year, and this finding had not been noted at that time. Gonioscopy revealed focal involvement of the ciliary body, but the adjacent angle was normal. The lesion seemed solid on transillumination.

NG is a 29-year-old woman who was noted on a routine eye examination to have a pigmented lesion of her left temporal iris root. The same optometrist had checked her in the prior year, and this finding had not been noted at that time. Gonioscopy revealed focal involvement of the ciliary body, but the adjacent angle was normal. The lesion seemed solid on transillumination.

Immersion scanning using a 20-MHz probe revealed a solid lesion of the anterior ciliary body (Fig. 1). It measured 1.6 mm by 1.5 mm. The finding of a probable ciliary body melanoma was discussed with the patient, and she elected to observe it for growth with repeat echography every 4–6 months.

Fig. 1

Immersion B-scan (20 MHz) of ciliary body melanoma (arrow)

Iris and ciliary body cysts are more common than solid lesions and are easily diagnosed on immersion scanning (Fig. 2). Multicystic lesions are not uncommon. It is important to differentiate them from tumors such as melanoma.

Fig. 2

Immersion scan (20-MHz probe) of iris/ciliary body cyst (arrow)

The correct diagnosis of anterior segment problems with timely therapy can be facilitated by echographic techniques.