The following is a summary of “Iris melanoma: Review of clinical features, risks, management, and outcomes,” published in the February 2024 issue of Dermatology by Cherkas, et al.
Primary uveal melanoma is a rare malignancy affecting approximately 8,000 individuals worldwide each year. It primarily involves the iris, ciliary body, and choroid, with iris involvement being the least common, representing only 4% of all uveal melanomas. Iris melanoma can arise from iris melanocytic nevus, iris melanocytosis, or de novo development. In a longitudinal study involving 1,611 patients with iris nevus, transformation into melanoma occurred in 2.6% by five years and 4.1% by 10 years, according to Kaplan-Meier estimates.
Certain factors predict the growth of iris melanocytic nevus into melanoma, denoted by the ABCDEF guide: A for age ≤40 years at presentation (HR = 3, P = .01), B for presence of blood (hyphema) (HR = 9, P < .0004), C for clock hour of tumor inferiorly (tumor location) (HR = 9, P = .03), D for diffuse flat tumor configuration (HR = 14, P = .02), E for ectropion uveae (HR = 4, P = .002), and F for feathery ill-defined margins (HR = 3, P = .02). At diagnosis, iris melanoma typically presents with a mean cross-sectional diameter of 5.5 mm and thickness of 2.1 mm, often accompanied by tumor seeding (28%) and secondary glaucoma (35%).
The review provided a comprehensive overview of iris nevus and melanoma, covering relevant demographic and clinical data, risk factors for tumor growth, management strategies, and prognosis. It aimed to enhance clinicians’ understanding of this rare malignant condition, thereby improving patient care and outcomes.
Reference: sciencedirect.com/science/article/abs/pii/S0738081X23001748
