Diagnostic Fine-Needle Aspiration Biopsy for Iris Melanoma

Purpose: The aim of this study was to describe a case of iris melanoma diagnosed by fine-needle aspiration biopsy (FNAB) with review of the literature. Design: This study presents a case report and review of the literature. Methods: A 76-year-old white man presented with iris melanoma arising from preexisting iris nevus that was confirmed cytologically by a transcorneal FNAB. Results: A pigmented lesion on the left iris extending from 3 to 8: 30 o'clock, from the iris root to the pupillary margin without ectropion uveae, was biopsied through 1-mm clear corneal incision. A short 25-gauge needle was inserted into the tumor while applying aspiration, and 10Y0 suture was used to close the wound. Cytopathology confirmed the presence of spindle-shaped cells with conspicuous cytoplasmic melanin and nuclear atypia consistent with the diagnosis of melanoma. There were no intraoperative or postoperative complications. The patient was subsequently treated with radiation plaque brachytherapy. Conclusions: Although indicated only in minority of cases, it is important to consider FNAB for the diagnosis and management of iris lesions.