Choroidal leiomyoma of vascular origin

Area of Science:

• Ophthalmology
• Surgical Pathology
• Oncology

Background:

• Choroidal tumors can present diagnostic challenges, with malignant melanoma being a common suspicion.
• Differential diagnoses for unusual choroidal masses include vascular tumors, gliomas, and neural neoplasms.

Observation:

• A 57-year-old male presented with a clinically suspected malignant melanoma of the left eye.
• Microscopic examination revealed an unusual extraocularly extending choroidal tumor.
• Previous interpretations included angiosarcoma, atypical angioma, glioma, and neurilemoma.

Findings:

• Electron microscopy of deparaffinized tissue confirmed the tumor's smooth muscle origin.
• Numerous pericytes were observed associated with prominent vascular channels.
• The findings suggest a unique myogenous tumor of the choroid with a probable vascular origin.

Implications:

• This case expands the spectrum of rare choroidal tumors.
• Accurate histopathological diagnosis, including electron microscopy, is crucial for rare ocular neoplasms.
• Understanding the vascular origin of this myogenous tumor may inform future research and treatment strategies.