SARCOMA may arise primarily in either part of the uveal tract. In the iris it ap pears as a tumor which grows very slowly, usually brown and deeply pigmented sometimes of lighter color, with visible vessels.
Case of primary sarcoma of the iris, with secondary nodes in the choroid. The growth was first notieed when the patient was ten years old, and was prob ably congenital. When the patient was fifty-eight years old enneleation was per formed, the growth having destroyed the eye. The small melanoma had developed into a sarcoma, which had infiltrated all the. structures of the globe. From twenty-eight melanotie tumors of the iris, twenty-six were found malignant. Whiting (Archiv f. Augenh., Mar., '92).
The differential diagnosis with the ophthalmoscope between lencosarcoma and melanotic sarcoma can only be made either when the pigment of the hexagonal pigment-layer is absent, as in an albino, or where this layer has been broken through by the growth. Hill Griffith (Med. Chronicle, May, '92).
Case of simple melanoma of the iris, with (associated) symptoms simulating shnple non-inflammatory glaucoma. The alteration in the color of the left iris had been increasing for a period of seven years and .had been accompanied by a gradual loss of vision. The melanosis had partly saturated the sclera also and its vessels. The blood-vessels of the iris were slightly enlarged, but not tortuous. There w as a deep glaucomatous excava tion of the nerve, and the field of vision was limited to the temporal side. Mullen (Texas Med. Jour., Nov., '96).
Primary sarcoma of the iris may be mistaken for gamma, for simple mela noma, or for primary tubercle of the iris. A simple melanoma becomes darker and darker, while a melanosareonza ordinarily retains its primary shade. A melanoma is also a congenital ,growth, while sar coma is not. Whenever a gumma of the iris appears, there is a severe iritis, whereas in the early stage of sarcoma of the iris there are no inflammatory symp toms. in gumma of the iris there is a specific history, with other symptoms ref erable to syphilitic infection. The color of the gumma is either an iron•red or deep yellowish red, while that of sarcoma is reddish gray, blackish or light brown, or flesh-color (Andrews). Guznma is non-vascular and yellowish white in color at the summit, but at the base it is vas cular and has a yellowish-red border (Fuchs). The administration of anti
syphilitic remedies for a short time in large doses will clear up the diagnosis.
Tuberele of the iris is of much more rapid growth than sarcoma, and in color is of a light yellowish white, or light grayish white, or light grayish yellow (Andrews). .As a rule, no vessels are seen on its surface, w hereas in sarcoma superficial vascularization ean usually be detected. The larger number of cases of tubercle have occurred in subjects under fifteen years of age, whereas the larger number of cases of sarcoma have been found in older persons. Tubercle is much more irregular in form than sarcoma, and the accompanying inflammatory symptoms also appear earlier. Clarence A. Veasey (Annal. of Ophth., Oct., '97).
Sarcoma of the ciliary body may first manifest itself in the pupil or by pushing forward the iris; or it becomes adherent to the iris and by its growth drags the iris away from its ciliary attachment, re vealing the tumor beneath.
The fourth reported ease of melanotie sarcoma of tbe ciliary body. The tumor involved the ciliary body, extending forward into the anterior chamber, and backward into the centre of the vitreous, 15 by 13.5 millimetres. It was deep brown and light gray in color, and di vided by strongly pigmented septa into three small parts and one large portion. Microscopically, it presented the usual features of a mixed-cell, pigmented, choroidal sarcoma. Hirschberg and A. Ilirnbacher (Centralh. f. prakt. Augenh., Jan., '95).
Case of melanosareoma of the ciliary body observed in an early stage, asso ciated with apparent iridodialysis. Ali eroscopiefilly the tumor consisted of round and spindle-shaped unpigmented cells extending from the ciliary body. Anteriorly the growth was preceded by an increase in the pigment-cells in the ciliary body, the root of the iris, and the membrane of Descemet, which gave the. clinical appearance of iridodialysis. Pig 1., t yi le also found bety cell the 'al...Hit of t he sch ./, ill 1110 bitlott Vt'SSCIS, 11 A t 1.11 111 tilt` I 0111111lb:1r FAIOW II 311 C.41 iy 111e1.1,111SIS. Walter (Archly f At1,0 nil , B. 31, 11. 11, '961.