2020–2021 BCSC Basic and Clinical Science Course™
4 Ophthalmic Pathology and Intraocular Tumors
Part II: Intraocular Tumors: Clinical Aspects
Chapter 17: Melanocytic Tumors
Epithelial Tumors of the Uveal Tract and Retina
Adenoma and Adenocarcinoma
Benign adenomas of the nonpigmented and pigmented ciliary epithelium may appear clinically indistinguishable from amelanotic and pigmented melanomas arising in the ciliary body. Benign adenomas of the RPE are rare. These lesions are oval, deeply pigmented tumors that arise abruptly from the RPE. Adenomas rarely enlarge and seldom undergo malignant change. Adenocarcinomas of the RPE are also very rare; only a few cases have been reported. They typically have feeder retinal vessels and may be associated with yellowish lipid exudates. Although these lesions display malignant features on histologic examination, their metastatic potential is minimal. Adenomas and adenocarcinomas show high internal reflectivity on ultrasonography.
Fuchs adenoma (also called pseudoadenomatous hyperplasia) is usually an incidental finding at autopsy and rarely becomes apparent clinically. It appears as an irregular, glistening, nonpigmented white or tan tumor arising from the inner surface of the pars plicata. It consists of benign proliferation of the nonpigmented ciliary epithelium with production of basement membrane material. See also Chapter 11.
Excerpted from BCSC 2020-2021 series: Section 4 - Ophthalmic Pathology and Intraocular Tumors. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.