Orbital Leiomyoma: A Case Report

Jongshin Kim; Nam Ju Kim

doi:10.3341/jkos.2009.50.2.294

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Kim and Kim: Orbital Leiomyoma: A Case Report

Original Article

J Korean Ophthalmol Soc 2009;50(2):294-298.

Published online: 3 January 2009

DOI: https://doi.org/10.3341/jkos.2009.50.2.294

Orbital Leiomyoma: A Case Report

Jongshin Kim, MD¹, Nam Ju Kim, MD^1,²

¹Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea

²Department of Ophthalmology, Seoul National University Bundang Hospital, Gyeonggi, Korea

Address reprint requests to Nam Ju Kim, MD Department of Ophthalmology, Seoul National University Bundang Hospital #300 Gumi‐dong, Bundang‐gu, Seongnam-si, Gyeonggi‐do 463‐707, Korea Tel: 82-31‐787‐7379, Fax: 82-31‐787‐4057, E-mail: resourceful@hanmail.net

Received 28 February 2008 Accepted 2 September 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of orbital leiomyoma presenting with proptosis.

Case summary

A 69‐ year‐ old woman presented with a 3‐ month history of proptosis in her left eye. Intraocular pressure was 17 mmHg in her right eye and 23 mmHg in her left eye. There was a left hypotropia on upgaze. A fundus examination showed retinal folds in the superotemporal area in her left eye. Computed tomography revealed a 2.6 cm‐ sized well‐ defined enhancing solid mass in the superotemporal extraconal space of the left orbit, pushing her left eye forward. Lateral orbitotomy, tumor removal, and biopsy were performed. Pathological findings showed a fascicular pattern of benign spindle cells with mild cellular pleomorphism and hyaline degeneration, without mitotic figures. Immunohistochemical stain was positive with smooth muscle actin (SMA), which was compatible with orbital leiomyoma.

Conclusions

Orbital leiomyoma is rare, but it should be considered as a differential diagnosis of orbital tumor when the presenting symptom is proptosis and limitation of ocular movement.

Keywords: Orbital leiomyoma, Orbital tumor, Proptosis

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Figure 1.

Photographs of the patient: Note a proptosis and slight hypotropia of the left eye.

Figure 2.

Orbital CT findings of the patient: A well-defined solid mass (arrow) was found in the superotemporal extraconal space of the left orbital cavity. The tumor was enhanced in centripetal pattern from the periphery to the central area. Invasion to the adjacent structures was not noted.

Figure 3.

Gross pathologic finding of the excised mass: a 2.6 cm-sized encapsulated white irregular solid mass was dissected from superotemporal extraconal space of the left orbit.

Figure 4.

Light micrographs of the excised mass: (A) Microscopic features of leiomyoma. The tumor is composed of benign spindle cells showing mild cellular pleomorphism, hyaline degeneration, without mitotic figures (H&E, ×400) (B) Immunohistochemical staining of SMA shows irregular packets and fascicles of spindle cells. (SMA, ×400) (C-F) Immunohistochemical staining was negative for desmin, CD34, S-100 and ALK. (desmin, CD34, S-100, ALK, ×400)

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