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Results: biopsy was avoided due to hemorrhage and dissemination risk; iodine-125 plaque brachytherapy was performed, with a later radiation-induced cataract managed by surgery, and five-year control without recurrence. Conclusion: plaque brachytherapy provides effective long-term control of DICER1-associated disease.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/plaque-brachytherapy-for-dicer1-associated-ciliary-body-medulloepithelioma/417364/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/plaque-brachytherapy-for-dicer1-associated-ciliary-body-medulloepithelioma/417364.png","ImageObject",300,407,{"name":42,"@type":43},"acoobca","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",5,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why was biopsy not performed in the case report?","Question",{"text":63,"@type":64},"Biopsy was avoided because it carried risks of hemorrhage and tumor cell dissemination.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What treatment was used for the DICER1-associated ciliary body medulloepithelioma?",{"text":68,"@type":64},"The patient received iodine-125 plaque brachytherapy.",{"name":70,"@type":61,"acceptedAnswer":71},"What was the patient’s outcome after treatment?",{"text":72,"@type":64},"Five years after brachytherapy, the patient maintained excellent visual acuity with no signs of tumor recurrence, though a radiation-induced cataract later required 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\nMedulloepithelioma  \nMojtaba Abrishami1,2, Akbar Beiki-Ardakani3, Hatem Krema1  \n1Department of Ophthalmology and Vision Sciences, Ocular Oncology Service, Princess Margaret Cancer Center/University Health Network, University of Toronto, Toronto, Canada, 2Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran, 3Radiation Medicine Program, Princess Margaret Cancer Centre,  \nUniversity Health Network, Toronto, Ontario, Canada  \nAbstract  \nPurpose: To report the outcome of a ciliary body medulloepithelioma associated with DICER-1 syndrome treated with iodine-125 plaque brachytherapy.  \nMethods: An 11-year-old male with a DICER1 gene mutation, who was previously treated for pineoblastoma with craniospinal radiotherapy and systemic chemotherapy at the age of three, was referred to assess a vascularized retrolental mass in his left eye. The clinical and ultrasound evaluations, besides his initial diagnosis of DICER-1 syndrome, suggested a ciliary body medulloepithelioma.  \nResults: No biopsy was performed given the risks of hemorrhage and tumor cell dissemination. The patient underwent iodine-125 plaque brachytherapy. Although the patient developed a radiation-induced cataract, it was eventually treated with cataract surgery. Five years after brachytherapy, the patient maintained excellent visual acuity with no signs of tumor recurrence.  \nConclusion: Plaque brachytherapy is effective in achieving long-term control of DICER1-associated medulloepithelioma.  \nKeywords: Ciliary body, DICER1 syndrome, Medulloepithelioma, Plaque brachytherapy  \nAddress for correspondence: Mojtaba Abrishami, Eye Research Center, Khatam‑Al‑Anbia Eye Hospital, Qarani Blvd, Mashhad 9195965919, Iran.  \nE‑[mail: mojtaba_abrishami@yahoo.com](mail: mojtaba_abrishami@yahoo.com)  \nSubmitted: 30‑Jan‑2025; Accepted: 05‑Aug‑2025; Published: 19‑Dec‑2025  \nIntroductIon  \nMedulloepithelioma is a rare, congenital intraocular tumor that arises from the primitive medullary epithelium, typically presenting in childhood. 1 Most patients present between 2 and 10 years of age with loss of vision, pain, leukocoria, or conjunctival congestion. The mass appears as a grey-white ciliary body lesion with intratumoral cysts. A neoplastic cyclitic membrane with extension to the retrolental region is characteristic. It may lead to complications like neovascular glaucoma or retinal detachment. 1-3 Medulloepitheliomais among the differential diagnoses of pediatric-age leucocoria. Extraocular extension is uncommon but significantly increases the risk of metastasis.4 In some cases, medulloepithelioma is also linked to the DICER1 gene  \n\n| Access this article online |  |\n| --- | --- |\n| Quick Response Code:\u003Cbr>| Website:\u003Cbr>[https://journals.lww.com/joco](https://journals.lww.com/joco) |\n|  | DOI:\u003Cbr>10.4103/joco.joco_30_25 |\n\nmutation, particularly associated with pleuropulmonary blastoma (PPB) .5  \nTreatment modalities depend on the tumor size and extent of invasion. Conventionally, enucleation has been the preferred option for advanced or extensive cases. However, for small, localized tumors, conservative treatments such as cryotherapy, partial lamellar sclerouvectomy, and plaque radiotherapy have been utilized. Plaque brachytherapy is favored as a localized form of irradiation that could preserve the globe and maintain visual function in selected patients.Although rarely reported, intra-arterial or intravitreal chemotherapy has also been used in a few cases.1-3,6  \nThis case report demonstrates the use of plaque brachytherapy formedulloepithelioma associated with the DICER1 mutation as  \nThis is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License (CC BY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially wit","cbCailq5aKhPsF2b","https://ap.wps.com/l/cbCailq5aKhPsF2b","pdf",1156650,"English","# Abstract\n## Introduction\n## Case Report\n## Methods\n## Results\n## Conclusion","[{\"question\":\"Why was biopsy not performed in the case report?\",\"answer\":\"Biopsy was avoided because it carried risks of hemorrhage and tumor cell dissemination.\"},{\"question\":\"What treatment was used for the DICER1-associated ciliary body medulloepithelioma?\",\"answer\":\"The patient received iodine-125 plaque brachytherapy.\"},{\"question\":\"What was the patient’s outcome after treatment?\",\"answer\":\"Five years after brachytherapy, the patient maintained excellent visual acuity with no signs of tumor recurrence, though a radiation-induced cataract later required surgery.\"}]","Plaque Brachytherapy for DICER1-Associated Ciliary Body Medulloepithelioma | PDF",1790608973]