title: Utility of a biopsy in suspicious pigmented iris tumors.
abstract: BACKGROUND
  In the presence of pigmented iris lesions evocative of malignant melanoma and implying oncological treatment, a foregoing biopsy to exclude a benign lesion may seem a reasonable approach. After examining patient files, the utility of such a diagnostic approach was explored.
  
  
  METHODS
  Retrospective, consecutive histopathologic case series of 10 pigmented iris tumor specimens excised since 1993. Histopathologic diagnosis was compared with final diagnosis and outcome in the patient's medical chart.
  
  
  RESULTS
  Five biopsies had only nevus cells, whereas ulterior clinical data or histopathologic examinations were compatible with the diagnosis of malignant melanoma. One biopsy contained insufficient sample tissue. Four biopsies confirmed clinical suspicion of iris melanoma.
  
  
  CONCLUSIONS
  In the current case series, 6 out of 10 biopsies provided a falsely reassuring negative or an inconclusive result. Modern management techniques such as ultrasound biomicroscopy and proton therapy of the whole anterior segment have equally diminished indications for a biopsy. In cases clinically evocative of iris melanoma, a biopsy has only a relative value.
authors.affiliation: Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland. ann.schalenbourg@ophtal.vd.ch
authors.forename: Ann
authors.initials: A
authors.lastname: Schalenbourg
authors.forename: Sylvie
authors.initials: S
authors.lastname: Uffer
authors.forename: Leonidas
authors.initials: L
authors.lastname: Zografos
mesh_terms: D000328:Adult; D001706:Biopsy; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D032801:Iridectomy; D015811:Iris Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy; D033401:Microscopy, Acoustic; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy; D011522:Protons; D012189:Retrospective Studies
chemical_list: D011522:Protons