Abstract

P 240

Solitary iris process as the first manifestation of sarcoidosis stage III

Pogorelov P., Mardin C., Kruse F. E., Jünemann A.
Department of Ophthalmology, University of Erlangen-Nuremberg, Erlangen

Objective: To describe a case of an unusual unilateral vascularized iris tumor as the first manifestation of sarcoidosis stage III in a 25-year-old-man.
Results: At clinical examination, the solitary tumor appeared similar to amelanotic malignant melanoma of the iris with concomitant granulomatous iridocyclitis with corneal precipitates. The conjunctival biopsy revealed epitheloid cell granulomas with insular central necrosis (caseating granulomas). Profound tuberculosis diagnostics (tuberculin skin-test, M. tuberculosis DNA analysis in bronchoalveolar lavage and in conjunctival biopsy) remained negative. Extensive systemic check-up revealed the clinical pattern of sarcoidosis stage III with multiple mediastinal and hepatic lymph nodes involvement and scrotal granulomas. The iris tumor and other systemic manifestations resolved under topical and systemic steroid therapy within few weeks.
Conclusions: An isolated iris granuloma can mimic amelanotic melanoma or metastatic iris tumor. In our case, the solitary iris tumor was the single ocular manifestation of advanced systemic sarcoidosis. Histologically, central necrosis within epitheloid cell granulomas can also occur in sarcoidosis.

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