Clinical survey of 3680 iris tumors based on patient age at presentation.
OBJECTIVE
To report the spectrum of iris lesions based on patient age at presentation.


METHODS
Retrospective, nonrandomized, single-center case series.


METHODS
We included 3680 iris tumors in 3451 patients.


METHODS
Chart review.


METHODS
Diagnostic category based on age.


RESULTS
The mean age at presentation was 48 years and there were 449 (12%) tumors in children (≤20 years), 788 (21%) in young adults (21-40 years), 1308 (36%) in mid adults (41-60 years), and 1135 (31%) in senior adults (>60 years). Of 3680 tumors, the diagnostic category was cystic (n = 768; 21%) or solid (n = 2912; 79%). The cystic tumors originated from iris pigment epithelium (IPE; n = 672; 18%) or iris stroma (n = 96; 3%). The solid tumors included melanocytic (n = 2510; 68%) and nonmelanocytic (n = 402; 11%). The melanocytic tumors comprised nevus (n = 1503; 60%), melanocytoma (n = 68; 3%), melanoma (n = 645; 26%), and melanocytosis (n = 64; 3%). Of 2510 melanocytic tumors, the first and second most common diagnoses by age (children, young adult, mid adult, senior adult) were nevus (53%, 57%, 63%, and 63%, respectively) and melanoma (17%, 27%, 26%, and 27%, respectively). The nonmelanocytic tumors included categories of choristomatous (n = 4; <1%), vascular (n = 57; 2%), fibrous (n = 2; <1%), neural (n = 3; <1%), myogenic (n = 2;, <1%), epithelial (n = 35; 1%), xanthomatous (n = 8; <1%), metastasis (n = 67; 2%), lymphoid (n = 12; <1%), leukemic (n = 2; <1%), secondary (n = 12; <1%), and nonneoplastic simulators (n = 198; 5%). The median age (in years) at diagnosis included cystic (39), melanocytic (52), choristomatous (0.7), vascular (56), fibrous (53), neural (8), myogenic (42), epithelial (63), xanthomatous (1.9), metastasis (60), lymphoid (57), leukemic (25.5), secondary (59), and nonneoplastic simulators (49). Overall, the 3 most common specific diagnoses (children, young adult, mid adult, senior adult) were nevus (25%, 36%, 47%, and 47%, respectively), IPE cyst (28%, 30%, 15%, and 14%, respectively), and melanoma (8%, 16%, 20%, and 19%, respectively).


CONCLUSIONS
In an ocular oncology practice, the spectrum of iris tumors includes cystic (21%) and solid (79%) tumors. The solid tumors were melanocytic (68%) or nonmelanocytic (11%). At all ages, the most common specific diagnoses were nevus (42%), IPE cyst (19%), and melanoma (17%).
Ocular Oncology Service, Suite 1440, Wills Eye Institute, 840 Walnut Street, Philadelphia, PA 19107, USA. carol.shields@shieldsoncology.com
Carol L
CL
Shields
Swarupa
S
Kancherla
Jinali
J
Patel
Priya
P
Vijayvargiya
Mayerling M
MM
Suriano
Emily
E
Kolbus
Ami
A
Badami
Priya
P
Sharma
Emily
E
Jacobs
Matt
M
Voluck
Zina
Z
Zhang
Rishav
R
Kansal
Patrick W
PW
Shields
Carlos G
CG
Bianciotto
Jerry A
JA
Shields
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000208:ethnology; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006630:Hispanic or Latino / Q000208:ethnology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015811:Iris Neoplasms / Q000145:classification / Q000208:ethnology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017678:Sex Distribution; D044465:White People / Q000208:ethnology; D055815:Young Adult