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Primary iris leiomyoma.

Gabrielle A Yeaney1, Sean Platt2, Arun D Singh2

  • 1Department of Anatomic Pathology, R. Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Survey of Ophthalmology
|November 29, 2016
PubMed
Summary
This summary is machine-generated.

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Primary iris leiomyoma is a rare tumor that can be mistaken for more common melanocytic lesions. This case highlights key diagnostic features, including immunohistochemistry and ultrastructural analysis, for accurate identification of this unusual iris tumor.

Area of Science:

  • Ophthalmology
  • Oncology
  • Pathology

Background:

  • Intraocular leiomyomas typically affect the ciliary body.
  • Primary iris leiomyoma is exceptionally rare and diagnostically challenging due to its similarity to amelanotic melanocytic tumors.

Observation:

  • A 58-year-old male presented with a 2-mm, round, translucent, pink iris lesion.
  • The lesion was surgically excised via sector iridectomy.

Findings:

  • Immunohistochemistry confirmed leiomyoma with smooth muscle actin and desmin positivity, and negative markers for melanocytic and endothelial tumors (S-100, HMB45, SOX10, MelanA, CD31, CD34, h-caldesmon).
  • Epstein-Barr virus-associated smooth muscle tumor was ruled out.
  • Ultrastructural analysis revealed cytoplasmic myofilaments and micropinocytotic vesicles.
Keywords:
amelanoticiris tumorleiomyomasmooth muscle tumoruveal neoplasms

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Implications:

  • This case underscores the importance of considering primary iris leiomyoma in the differential diagnosis of amelanotic, S-100-negative iris tumors.
  • Accurate diagnosis relies on a combination of clinical presentation, immunohistochemistry, and electron microscopy.
  • Further research into rare iris tumors can improve diagnostic accuracy and patient management.