A case of ciliary body leiomyoma penetrating the sclera

To describe a case of ciliary body leiomyoma that penetrated the sclera and migrated under the bulbar conjunctiva.

A 31-year-old woman was referred to our hospital with a clinical diagnosis of ciliary body tumor in the left eye. Her best corrected visual acuity at presentation was 24/20 OU. Slit lamp examination revealed a slight bulging at the thinned anterior temporal sclera, and dilated and tortuous episcleral vessels in her left eye. A brownish intraocular mass lesion was observed at the temporal periphery of the fundus. The tumor was considered to be a benign ciliary body tumor extending to the choroid; we therefore recommended conservative observation. When the patient was again referred to our hospital 12 years later, she presented with a dome-shaped, red, raised lesion at the temporal bulbar conjunctiva. The previously observed intraocular protrusion was evidently reduced. Although there was no change in visual acuity, the patient desired cosmetic improvement. The subconjunctival lesion was excised as far as possible via the bulbar conjunctiva. The histopathological diagnosis was leiomyoma, and cosmetic improvement was achieved.

Ciliary body leiomyoma is a benign tumor, but has the potential to perforate the sclera.