Recurrent Mesectodermal Leiomyoma of the Ciliary Body: A Case Report

Abstract

A 19-yr-old woman with a previous history of a mass of the right ciliary body presented with a decreased visual acuity of right eye. Clinicoradiologic examinations suggested a recurrent mass of the ciliary body. Enucleation of the right eye was performed under the impression of malignant tumor. On microscopic examination, the tumor was a mesectodermal leiomyoma of the ciliary body. On immunohistochemistry, the tumor cells were reactive to smooth muscle actin and vimentin, but not reactive to cytokeratin, S-100 protein, neurofilament, desmin, epithelial membrane antigen, HMB-45, glial fibrillary acidic protein, and synaptophysin. Electron microscopy revealed numerous thin longitudinally placed myofilaments and focal densities in the cytoplasms. In the review of the literature, only 27 cases of mesectodermal leiomyoma of the ciliary body were reported, however, there was no report of recurrent cases. Mesectodermal leiomyoma should be differentiated from other orbital spindle-cell tumors such as amelanotic melanomas and glial tumors. Immunohistochemical and electron microscopic studies may be useful for the correct diagnosis by showing smooth muscle differentiation in the tumor cells.

Acute Presentation of Mesectodermal Leiomyoma of the Ciliary Body

“…A few cases of leiomyoma presented as anterior staphyloma [11,12]. Although there is no report of recurrence or metastasis after enucleation, the regrowth of incompletely resected tumors has been reported [13]. …”

Comparison of the clinical characteristics and the results of treatment of leiomyoma in the ciliochoroid and choroid

“…However, six of the patients (86%) in five previous case studies and both of our cases of leiomyoma confined to the choroid were male (Table 1) (Jakobiec et al 1976;Jeon et al 2002;Perri et al 2002;Miyamoto et al 2007;Chiang et al 2015). Furthermore, some cases of uveal leiomyosarcoma have been reported, although there is no evidence that these leiomyosarcomas originated from benign lesions such as leiomyomas (Dugmore 1972;Park et al 2003;Cajaiba et al 2008). For this reason, different developmental mechanisms may play a role in uterine and intra-ocular leiomyoma, and we cannot conclude definitely that malignant change does not occur in intra-ocular leiomyoma.…”

Lenticular meridional astigmatism secondary to iris mesectodermal leiomyoma

“…7 We identified less than 30 cases of mesectodermal leiomyomas in the literature. [3][4][5][6]8 These tumors seldom originate from the iris or involve the anterior chamber. 6,7,9,[10][11][12] While the tumors are benign, they can recur if not completely excised.…”