Coexisting Phacoanaphylaxis and Choroidal Melanoma: An Unusual Intraocular Inflammation

ABSTRACT

Purpose: To describe an unusual case of panuveitis in coexisting choroidal melanoma and phacoanaphylaxis.

Methods: Clinical records of the patient with intraocular melanoma and pathologic findings of the affected eye were reviewed. Composition of inflammatory infiltrates involving the tumor and lens was evaluated immunohistochemically.

Results: Histologically, tumor showed a choroidal mixed cell type malignant melanoma with infiltration of inflammatory cells. The globe also showed typical features of phacoanaphylaxis, characterized by disruptions of the lens capsule with zonal granulomatous inflammation. The inflammatory infiltration revealed the predominant presence of both cytotoxic T cells and histiocytes in phacoanaphylaxis and intra-tumoral inflammation.

Conclusions: The current clinico-pathologic case report suggests that a long standing intraocular melanoma can present with phacoanaphylaxis. The immunophenotype of the inflammatory infiltrates at both sites, lens and the tumor, is similar, cytotoxic T cells and histiocytes, favoring a common immune inflammatory process directed at the tumor and the lens.

Keywords:

• Choroidal melanoma
• lens-induced uveitis
• phacoanaphylactic endophthalmitis
• phacoanaphylaxis
• phacogenic uveitis

DECLARATION OF INTEREST

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.