Tapioca Melanoma of the Iris: A Case Report

Purpose: To report an extremely rare case of tapioca melanoma of the iris in an Iranian patient. Case Report: A 50-year-old male patient presented with ocular pain and redness in the right eye for two weeks. The visual acuity was 7/10 and the intraocular pressure (IOP) was 30 mmHg. A lobulated amelanotic vascularized and nodular (tapioca-like) iris mass with a 180o extent was seen in the right eye. Incisional biopsy of the mass revealed atypical mixed type (epithelioid and spindle cell) melanoma. Brachytherapy with the ruthenium-106 plaque resulted in complete regression of the tumor. Conclusion: Tapioca melanoma of the iris should be considered in the differential diagnosis of patients presenting with nodular vascularized amelanotic iris mass and elevated IOP. Brachytherapy with ruthenium- 106 seems to be an effective treatment for tapioca melanoma of the iris.