Choroidal metastasis from leiomyosarcoma in two cases

Abstract

Leiomyosarcoma is a malignant tumor of mesenchymal cells and is the most common soft-tissue sarcoma. Leiomyosarcoma is a notably rare tumor in the ophthalmic region and can be of primary, secondary or metastatic origin. To the best of our knowledge, there has only been one published case of leiomyosarcoma metastasis to the choroid. In this case study, we report two cases of primary leiomyosarcoma with metastasis to the choroid of the eye. Both cases displayed systemic metastasis and showed response to high dose plaque radiotherapy. Despite its prevalence as the leading form of sarcoma, leiomyosarcoma rarely metastasizes to the ocular region.

Keywords: Choroid; eye; fine needle aspiration biopsy; leiomyosarcoma; metastasis; sarcoma; tumor; uvea.

Figure 1

A 66-year-old Caucasian male with juxtapapillary choroidal metastasis (a-c) before treatment and regressed tumor (d-f) after plaque radiotherapy

Figure 2

A 62-year-old Caucasian male with superonasal equatorial choroidal metastasis (a), with high to medium internal reflectivity on A scan (b) and mushroom shaped configuration on B-scan ultrasonography (c). Fine needle aspiration biopsy yielded a cohesive cluster of atypical spindle cells with hyperchromatic, elongated nuclei (d) and a mitotic figure (black arrow) (e) (Papanicolaou stain). Following plaque radiotherapy, tumor regression was documented but persistent vitreous hemorrhage and retinal detachment lead to poor visual acuity