J Korean Ophthalmol Soc > Volume 58(2); 2017 > Article
Journal of the Korean Ophthalmological Society 2017;58(2):230-234.
DOI: https://doi.org/10.3341/jkos.2017.58.2.230    Published online February 15, 2017.
Pigmented Mass in the Anterior Chamber Suspected of Granuloma Caused by a Metallic Foreign Body.
Min Seon Park, Sang Yul Choi, Sang Mok Lee
1Department of Ophthalmology, Hallym University Sacred Hospital, Hallym University College of Medicine, Anyang, Korea. lsm10003@gmail.com
2Department of Ophthalmology, Korea Cancer Center Hospital, Seoul, Korea.
금속 이물질에 의한 육아종으로 의심되는 전방내의 색소성 종괴
박민선1⋅최상열2⋅이상목1
한림대학교 의과대학 한림대학교성심병원 안과학교실1, 원자력병원 안과학교실2
Correspondence:  Sang-Mok Lee, MD, PhD
Email: lsm10003@gmail.com
Received: 16 June 2016   • Revised: 28 November 2016   • Accepted: 17 January 2017
Abstract
PURPOSE
To report on a patient with a brown pigmented mass in the anterior chamber suspected of a granuloma caused by a metallic foreign body and to review the relevant literature. CASE SUMMARY: A 63-year-old man presented with blurring in his right eye, which had initially began several years prior. Concentric corneoscleral brown pigmentation about 2 mm in diameter was found in the superonasal limbal area. A rectangular parallelepiped mass was observed in the superonasal anterior chamber, which was an even brown color with a small white portion, smooth-surfaced, and non-vascularized. The pupil was oval and dragged superonasally, possibly due to mild compression of the iris caused by the mass. In pre-enhanced orbital computed tomography, a round high signal intensity with a diameter of 3.0 mm was found in the superonasal anterior segment. Though excisional biopsy using the lamellar scleral flap was considered for exact diagnosis, this was not performed considering the clinical features are more indicative of granuloma than iris melanoma. Neither changes in the size of the mass nor the shape of the pupil were observed during the follow up period until 19 months after the first visit. CONCLUSIONS: When a pigmented mass in the anterior chamber is detected, benign and malignant iris tumors and granulomas should be considered for a differential diagnosis. The patient's exact past medical history and clinical features differentiating malignant and benign masses are important for proper diagnosis due to the difficulty in obtaining tissue diagnoses in some cases.
Key Words: Foreign body;Granuloma;Iris tumor;Melanoma;Metal


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