Observations on seven cases of intraocular leiomyoma. The 1993 Byron Demorest Lecture
J. A. Shields, C. L. Shields, R. C. Eagle Jr and P. De Potter
Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA.
A review of seven cases of intraocular leiomyoma personally managed by the
authors disclosed clinical and histopathologic characteristics that serve
to differentiate this uncommon tumor from uveal melanoma. Leiomyoma
generally occurs in younger patients and has a definite predilection for
females. It tends to affect the ciliary body and peripheral choroid rather
than the posterior choroid. In contrast to melanoma, which is located in
the uveal stroma, leiomyoma usually is located in the supraciliary or
suprachoroidal space. During transillumination, leiomyoma usually transmits
light readily, whereas most melanomas cast a shadow. If intraocular
leiomyoma is suspected clinically, the best management seems to be removal
by a modified lamellar sclerouvectomy. In contrast to melanoma, leiomyoma
shows positive immunoreactivity for muscle markers and negative
immunoreactivity for melanoma-specific antigen and neural markers.
