Clinical characteristics and surgical outcomes of mesectodermal leiomyoma of the ciliary body and choroid

Abstract

PurposeMesectodermal leiomyoma is a rare tumor that can arise from smooth muscle tissue in the iris or ciliary body or from heterotopic smooth muscle in the choroid. The purpose of this study was to describe the clinical characteristics and surgical outcomes of mesectodermal leiomyoma of the ciliary body and choroid.MethodsRetrospective observation case series of 8 patients who were diagnosed with mesectodermal leiomyoma with histopathologic and immunohistochemical confirmation.ResultsThe median age at presentation was 37.5 years. The median follow‐up period was 27 months. Ultrasonography showed dome‐shaped smooth surface with low to medium internal reflectivity and regular internal structure in all tumors. The tumor had a median largest base diameter of 10.4 mm and a median thickness of 7.7 mm. They revealed pinkish colored surface and vessels that more developed than other intraocular tumors. The tumors located on ciliary body only in 4 eyes, on choroid only in 2 eyes, and on ciliochoroid in 2 eyes. 6 patients who had tumors on ciliary body only or ciliochoroid underwent lamellar sclerouvectomy. 2 patients who had choroidal tumor received enucleation or partial excision for biopsy each. On immunohistochemistry, all the tumors were stained positively for smooth muscle actin and desmin. After lamellar sclerouvectomy, the tumor did not show recurrence in follow up period. But the patient that underwent partial removal of tumor on choroid showed irregularly changing surface with increasing size.ConclusionsMesectodermal leiomyoma did not show the recurrence after lamellar sclerouvectomy and malignant change of tumor. However these tumors are difficult to differentiate from other intraocular tumor and to conclude definitely that they do not develop malignant change because they have heterogeneity from benign leiomyoma of other body organs.