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Differential diagnosis of anterior chamber cysts with ultrasound biomicroscopy: ciliary body medulloepithelioma.
- Source :
-
Acta ophthalmologica Scandinavica [Acta Ophthalmol Scand] 2006 Feb; Vol. 84 (1), pp. 137-9. - Publication Year :
- 2006
-
Abstract
- Purpose: To describe a case with motile cyst in the anterior chamber in the right eye of a 7-year-old boy.<br />Methods: The right eye's visual acuity was 20/50. Intraocular pressure was 59 mmHg. Slit-lamp examination showed prominent rubeosis iridis and a grey-white mass floating freely in the anterior chamber. Ultrasound biomicroscopy revealed a cystic mass in the anterior chamber. A diagnostic cyclectomy with removal of the anterior chamber cyst was performed. Histopathology of the anterior chamber lesion showed an intact cyst composed of medullary epithelial cells. Medulloepithelioma with malignant criteria was diagnosed and the eye was enucleated.<br />Results: Pathology demonstrated an medulloepithelioma with a few mitotic figures and nuclear pleomorphisms within the ciliary body. The patient was followed for 8 months without any metastasis in the orbit or elsewhere.<br />Conclusion: Intraocular medulloepithelioma is a rare embryonic benign or malignant neoplasm typically diagnosed in the first decade of life as a ciliary body mass. A dislodged, free-floating anterior chamber cyst associated with neovascular glaucoma is typical of medulloepithelioma in children. This unique presentation should be differentiated from congenital iris epithelial, post-traumatic, epithelial, parasitic and neoplastic cysts. Ultrasound biomicroscopy is useful for analysing the structure of the anterior segment mass. Ciliary body medulloepithelioma is characterized by echogenic mass heterogeneity and an irregular surface containing multiple cystic cavities. Lack of glial differentiation may predict a better clinical outcome in primary neuroectodermal brain tumours.
- Subjects :
- Anterior Chamber parasitology
Child
Ciliary Body pathology
Cysts parasitology
Diagnosis, Differential
Eye Enucleation
Glaucoma, Neovascular diagnosis
Humans
Intraocular Pressure
Male
Microscopy, Acoustic
Neuroectodermal Tumors, Primitive pathology
Uveal Neoplasms pathology
Visual Acuity
Anterior Chamber diagnostic imaging
Ciliary Body diagnostic imaging
Cysts diagnostic imaging
Neuroectodermal Tumors, Primitive diagnostic imaging
Uveal Neoplasms diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1395-3907
- Volume :
- 84
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Acta ophthalmologica Scandinavica
- Publication Type :
- Academic Journal
- Accession number :
- 16445454
- Full Text :
- https://doi.org/10.1111/j.1600-0420.2005.00542.x