PURPOSE: To report a case of Ewing sarcoma metastatic to the iris. MET
HODS: A 19-year-old woman with metastatic Ewing sarcoma of the femur d
eveloped a diffuse, fluffy iris mass with a pseudohypopyon in the left
eye. A fine-needle aspiration biopsy confirmed iris metastasis, and e
xternal beam radiotherapy was given to the affected eye. RESULTS: The
iris mass responded initially to external beam radiotherapy and ongoin
g chemotherapy with vincristine, cyclophosphamide, doxorubicin, etopos
ide, and ifosfamide but recurred 5 months later. Subsequent radiothera
py with an iodine 125 plaque achieved further resolution of the iris t
umor. CONCLUSIONS: Ewing sarcoma can rarely metastasize to the iris. T
he diagnosis can be confirmed by fine-needle aspiration biopsy. Plaque
radiotherapy is a therapeutic alternative.