A case of pigmented leiomyoma of the iris

Are most intraocular "leiomyomas" really melanocytic lesions?

BACKGROUND

Intraocular smooth muscle tumors have long been a subject of controversy. The advent of immunohistochemistry with antibodies against HMB-45, S-100, smooth muscle actin, desmin, and vimentin has helped greatly in the distinction between smooth muscle tumors and melanocytic lesions.

METHODS

Twenty-seven archival tissue blocks from patients who had had intraocular leiomyomas or leiomyosarcomas diagnosed were located and fresh sections cut and stained for the above markers. The cases constituted 24 iris lesions and 3 ciliary body lesions.

RESULTS

All 24 iris tumors were reclassified as iris melanocytic lesions. Two of the three ciliary body leiomyomas retained their classification, and the third was reclassified as a spindle B-cell melanoma.

CONCLUSION

The authors suggest that intraocular leiomyomas are much rarer than previously suggested and that many of the cases previously reported in the literature are open to question.

Tumours of the anterior uvea. III. Oxytalan fibres in the differential diagnosis of leiomyoma and malignant melanoma of the iris

The diagnostic potential of oxytalan fibre demonstration in differentiating between leiomyomas and spindle-cell malignant melanomas of the iris was investigated. It was found that oxytalan fibres were abundant in leiomyomata, both between and around the tumour cells, whereas they were found in small numbers only and usually near the iris muscle in malignant melanomata. Their presence and distribution, therefore, appear to offer a satisfactory method of differentiating between these tumours. Since the human choroid and ciliary body normally contain oxytalan fibres, the above findings are not relevant to malignant melanoma of these structures. Naevi and regressing aggregates of iris melanoma cells away from the main tumour mass may similarly be surrounded by misleading amounts of these fibres.