a 52-year - old healthy man presented with intermittent ocular pain of indistinct duration in his right eye .
his best - corrected visual acuity ( bcva ) was 20/20 , and the intraocular pressure in the right eye was 10 mmhg .
slit - lamp and gonioscopic examination of the right eye showed an irregularly - shaped pigmented mass at the temporal iris root ( fig .
ultrasound biomicroscopy showed a ciliary body mass with extension into the iris root and medium internal reflection ( fig .
the basal diameter of the mass was 1.5 mm and the height was 1.3 mm .
magnetic resonance imaging of the head and orbit was unremarkable , and positron emission tomography of the ciliary body identified no significant fluorodeoxyglucose uptake in the orbit or the imaged body to suggest malignancy .
2b ) , and the tumor was positive for melanocytic markers ( melan a and hmb-45 ) .
a macrophage marker ( cd 68 ) confirmed the presence of melanophages in a scattered pattern .
the proliferative activity , estimated by the ki-67 labeling index , was less than 1.0% , implying a benign tumor .
histopathologic features were consistent with melanocytoma of the ciliary body with extension into the iris root .
slit - lamp photography taken on postoperative day 7 showed a small iridectomy site with good overall cosmesis ( fig .
the patient 's bcva remained 20/20 with an intraocular pressure of 12 mmhg . during one year of follow - up
, no signs of tumor recurrence were seen , and the patient reported resolution of the intermittent ocular pain in the involved eye .
melanocytoma of the ciliary body is typically identified at a late stage , as its location behind the iris eludes early detection with routine ophthalmic examination .
only after ciliary body melanocytomas extend into the iris root can they be visualized on anterior segment examination . in a report of ten patients with ciliary body melanocytomas , including a review of 30 additional cases
, 85% of patients displayed extension into the iris root or the trabecular meshwork , but only 12% had elevated intraocular pressure .
our patient exhibited extension of his ciliary - body melanocytoma into the iris root , but his preoperative intraocular pressure was within the normal range . in this series of ten patients , three were symptomatic , one of which reported soreness of the involved eye .
likewise , our patient presented with intermittent ocular pain , which could have been related to the presence of tumor in the ciliary body .
the differential diagnosis of a pigmented tumor of the ciliary body includes adenoma , adenocarcinoma , medulloepithelioma and , most importantly , malignant melanoma . although melanocytoma can usually be distinguished histopathologically , it can be difficult to clinically differentiate before surgery , especially from a malignant melanoma .
advised surgical removal rather than observation for management of pigmented lesions of the ciliary body due to both the difficulty in clinically distinguishing a melanocytoma from a malignant melanoma and the frequent occurrence of necrosis ( 36% ) seen in ciliary body melanocytomas . if serious intraocular complications are not present , such as massive necrosis of a large tumor , severe destruction of chamber angle structures , or massive hemorrhage , and if technically feasible , iridocyclectomy under lamellar scleral flap seems an apt choice for the surgical treatment of ciliary body tumors . in summary ,
melanocytoma of the ciliary body is a rare tumor that can invade chamber angle structures and present as a pigmented mass at the iris root .
we present a case of ciliary body melanocytoma which presented as an iris mass with intermittent pain that was successfully managed with an iridocyclectomy .
 we report a case of ciliary body melanocytoma in a korean patient , which presented as an intermittently painful pigmented iris mass and was successfully managed by iridocyclectomy . a 52-year - old healthy man presented with an irregularly - shaped and heavily - pigmented mass at the iris root of his right eye . 
 visual acuity of the right eye was 20/20 with normal intraocular pressure . 
 ultrasound biomicroscopy showed a 1.5x1.3-mm ciliary - body mass with extension into the iris root . 
 iridocyclectomy with scleral resection under a lamellar scleral flap was performed , and the histopathologic features of the resected tissue were consistent with melanocytoma of the ciliary body . 
 the patient 's visual acuity remained 20/20 with good postoperative cosmesis . during one year of follow - up 
 , no signs of tumor recurrence were seen , and the patient reported resolution of the intermittent ocular pain in the involved eye . 
Case Report
Discussion