Iris melanoma in children: Current approach to management

Iris melanoma usually affects middle aged, Caucasian patients with light colored eyes. Pediatric iris melanoma is rare. A 15-year-old Caucasian male presented with 1-month history of a brown nodule in the inferotemporal aspect of his left eye. Iris nevus was diagnosed, and the patient was observed. Nearly 2 years later the lesion had grown in basal diameter and thickness, and the tumor was excised by partial lamellar scleral flap and sector iridectomy. Histopathology confirmed spindle cell iris melanoma. Two years post-operatively, tumor recurrence with anterior chamber angle involvement and secondary glaucoma developed. He was then treated with custom designed Iodine(125) plaque radiotherapy. This case demonstrates the recurrence of iris melanoma despite proper initial surgical management, and outlines current management options for pediatric iris melanoma.