Case of the Month
Section Editor: Nicholas Stence, MD
Children's Hospital Colorado, Aurora, CO
January 2015
Next Case of the Month coming February 3 . . .
Uveal Leiomyoma
- Leiomyoma is a rare benign tumor of smooth muscle origin, which in the orbit can arise in the uvea (iris, ciliary body, and heterotopic smooth muscle of the choroid).
- Uveal leiomyomas often demonstrate a slow growth pattern. They can extend into the anterior chamber and produce ocular complications such as subluxation of the lens, glaucoma, and retinal detachment. Atypically, they can extend through the sclera into the orbit.
- Clinical Presenetation: Young, middle-aged women. Lenticular astigmatism.
- Fundoscopic Exam: Yellowish-white highly vascularized elevated mass
- Key Diagnostic Features:
- Well-defined non-infiltrative mass arising in the uvea (the ciliary body and peripheral choroid, rather than the posterior choroid, and involving the supraciliary or suprachoroidal space in terms of location of the globe wall stratification)
- Hyperintense to the vitreous on T1WI, hypointense on T2WI, and demonstrating enhancement
- Mild diffusion restriction can be seen.
- Rarely, sarcomatous degeneration can occur.
- DDx:
- Melanoma
- Metastasis
- Hemangioma
- Rx:
- Conservative management
- Sclerouvectomy
- Trans-scleral resection
- Enucleation
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