Malignant melanoma of the iris: recurrence after 19 years

Late recurrences of malignant melanoma of the iris are rarely reported. The case of a patient who had apparently had a spindle and nevoid cell melanoma totally excised from his iris is presented. Two and a half years later he sustained blunt trauma and developed retinal detachment in the same eye. The eye became phthisic after two unsuccessful attempts to repair the detachment. Seventeen years later he was seen with discomfort in the eye and was found to have a ruptured globe with prolapse of dark jelly-like material. Pathologic study revealed this to be recurrent spindle-B melanoma. This case, along with two similar cases from the literature, emphasizes that iris melanomas can recur many years after the original excision and that long-term follow-up is indicated.