The most common indication for cyclectomy is removal of a neoplasm involving the peripheral iris and/or the ciliary body.
Most cyclectomy procedures are excisional biopsy: the goal of the resection is to excise the lesion entirely. A deceptively large amount of iris tissue may need to be resected to ensure that the lateral resection margins are not involved by tumor.
In order for the pathologist to evaluate the tissue sample margins, it is important that the iris tissue component of the resected tissue not curl after being placed in formalin.
The surgeon should place the resected tissue on a flat mount of absorbable material and allow moisture from the specimen to run off into the mount until the tissue sample adheres to the mount (no longer than 30 seconds).
The mount with the adherent tissue should be placed as an open-faced sandwich into a collection vial with formalin. Agitate the vial gently until the mount and tissue sink into the container.
The histologic evaluation of heavily pigmented tumors such as melanocytomas or melanomas may require the preparation of slides that are bleached to remove melanin.
The pathologist has two goals:
- Rendering the correct diagnosis.
- Describing the resection margins.
The histologic differential diagnosis is narrow: melanoma, melanocytoma, leiomyoma, and focal granuloma.
During the gross examination, it is important to sample the lateral and medial resection margins. It is also important to comment on the posterior resection margin. The anterior margin is most likely the pupillary border and not a true resection margin.
It is helpful to section the specimen between the crests of the pars plicata to ensure proper orientation.
If you have more questions about cyclectomy or iridocyclectomy specimens, please contact one of us:
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