MR imaging findings of uveal leiomyoma: three cases

Abstract

Leiomyoma is a rare tumor arising from the uveal tract. Fundoscopically, it appears as a yellowish-white, elevated mass and cannot be readily distinguished from melanoma or other uveal tumors. Cross-sectional imaging may have an important role, particularly when the opaque ocular media or a vitreous hemorrhage precludes a clear ophthalmoscopic view. In this respect, radiologists should be aware of suggestive findings of uveal leiomyoma to avoid an incorrect diagnosis and unnecessary radical surgery. We report MR imaging findings of three cases of uveal leiomyoma.

Fig 1.

A 24-year-old man with sudden decrease of left visual acuity. A, Fundus photograph shows a dark, large, circumscribed, view-obstructing mass. B, Transocular sonography reveals a well-marginated endophytic mass with low internal reflectivity (arrows). Subretinal effusion is also observed (arrowhead). C, The mass located at the ciliochoroidal region is large, protuberant, and isointense to brain on a precontrast T1-weighted axial image (open arrow). Small amount of subretinal hemorrhage is noted (arrowhead). D, T2-weighted fast spin-echo axial image also shows an intraocular mass isointense to brain.

Fig 1.

(continued) E, On gadolinium-enhanced T1-weighted axial image, a homogeneous, enhancing mass is seen at the ciliochoroidal region (open arrow), as is a small amount of nonenhancing subretinal hemorrhage around the posterior pole (arrowhead). F, Low-magnification photograph of a cut specimen shows a well-circumscribed ciliochoroidal mass involving the whole stroma of the choroids (hematoxylin and eosin staining; magnification ×2). C indicates ciliary body; E, subretinal effusion; L, lens; N, optic nerve; and T, tumor. G and H, Hematoxylin and eosin staining (G) shows spindle cells arranged in intersecting fascicles, and tumor cells that have cigar-shaped nuclei with blunted end (arrowheads). The chromatin pattern is vesicular and mitotic figures are not seen. The tumor cells are positively stained for smooth muscle-specific actin (H).