title: Biopsy of an anterior episcleral nodule as an aid in managing a ciliary body melanocytic tumor.
abstract: OBJECTIVE
  To demonstrate the value of a diagnostic biopsy of a fixed episcleral nodule overlying a uveal mass.
  
  
  METHODS
  Clinicopathologic report with immunohistochemical investigations.
  
  
  RESULTS
  B-scan ultrasonographic biomicroscopy disclosed in a 67-year-old man an asymptomatic placoid ciliary body tumor measuring 1.28 mm in thickness underlying a poorly pigmented, fixed episcleral nodule 0.56 mm in thickness. Biopsy of the episcleral nodule displayed benign nevus-type spindle cells with small nuclei, punctate nucleoli, no mitoses, and scattered melanophages. Immunohistochemistry demonstrated that the tumor cells were Ki67 negative (proliferation index, 0) and MART-1, HMB-45, and microphthalmia-associated transcription factor positive, all melanocytic markers. The melanophages but not the tumor cells were CD68 positive, a histiocytic marker.
  
  
  CONCLUSIONS
  The results from biopsying an episcleral nodule can help to select among therapeutic options in managing an associated ciliary body tumor. A 1-year follow-up study and 3 sequential ultrasonographic studies in the current patient have failed to document the growth of the intraocular tumor, further confirming that it is a nevus. The excised epibulbar tumor has not recurred.
authors.affiliation: David G. Cogan Laboratory of Ophthalmic Pathology, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA. fred_jakobiec@meei.harvard.edu
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Jakobiec
authors.forename: Evangelos S
authors.initials: ES
authors.lastname: Gragoudas
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Colby
mesh_terms: D000368:Aged; D001706:Biopsy; D002924:Ciliary Body / Q000473:pathology*; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology*; D014604:Uveal Neoplasms / Q000473:pathology*