Iris Melanoma-A Rare Ocular Tumour

Uveal melanoma is a rare condition, especially in the Asian population that can be overlooked as a diagnostic consideration, leading to delayed identification. We reported the case of a 69-year-old Chinese man who presented with an iris mass that was initially treated as a cyst. The mass continued to grow in size, which raised suspicion of other infective causes or malignancy. Following the initial uveitic workup, the patient was found to be positive for QuantiFERON-TB test. Tumour markers and chest X-rays were unremarkable. The patient was treated for iris granuloma secondary to tuberculosis. However, the lesion continued to grow, prompting us to perform an excisional biopsy. Histopathological analysis demonstrated a mixed cellular (both spindle and epithelioid) pathology. The mixed cellular type has a higher metastatic potential compared to other histopathological types. This case highlighted the importance of ruling out malignant aetiology in cases of enlarging iris lesions to mitigate the risks of further complications.