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Case Reports
. 2022 May 11:26:101580.
doi: 10.1016/j.ajoc.2022.101580. eCollection 2022 Jun.

Conjunctival leiomyosarcoma

Aluisio Rosa Gameiro Filho  1 , Ana Marisa Pires Castello Branco  1 , Moacyr Pezati Rigueiro  2 , Melina Correia Morales  1 , Rubens N Belfort  1
Affiliations
Case Reports

Conjunctival leiomyosarcoma

Aluisio Rosa Gameiro Filho et al. Am J Ophthalmol Case Rep. .

Abstract

Purpose: Leiomyosarcoma (LMS) is a mesenchymal neoplasm with smooth muscle differentiation, being considered one of the most common soft tissue sarcomas. However, it rarely affects the eye, and when it does, it is usually located in the orbit, being extremely rare in the conjunctiva.

Observations: We report a case of a 45 years old male patient, with a recurrent rapid growing conjunctival mass on the temporal limbus of his left eye, which was excised, and the anatomopathological report was suggestive of a grade 1 leiomyosarcoma. Since the lesion was recurrent, we decided to perform an extended enucleation for treating this condition. Nevertheless, the patient is being followed up to 30 months, with systemic metastasis screening, showing no other lesions or recurrences.

Conclusions and importance: Conjunctival leiomyosarcoma is an extremely rare ocular tumor, which can be clinically indistinguishable from other conditions such as squamous cell carcinoma, so, biopsy is essential. Albeit there is no standard treatment, complete surgical removal with safety margins is mandatory.

Keywords: Conjunctiva; Eye; Leiomyosarcoma; Sarcoma; Soft tissue tumours; Tumor.

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Figures

Fig. 1
Fig. 1
Biomicroscopy showing a whitish elevated and vascularized lesion in the temporal limbus and temporal conjuntiva. An infiltrative aspect is noticeable, as well as extension to the cornea, which presents folds in the perilesional region. A retraction of the tarsal conjunctiva can also be seen.
Fig. 2
Fig. 2
Histopathological analysis showing atypical fusiform cells and nuclear pleomorphism (A). Atypical mitosis can be seen on image B (Hematoxylin-Eosin staining 400x).
Fig. 3
Fig. 3
Histopathological analysis showing scleral invasion (image A, H-E 100x) and corneal invasion (image B, H-E 40x).
Fig. 4
Fig. 4
Immunohistochemistry analysis shows staining for A = Smooth muscle actin (200x). B= Calponin (400x). C = Desmin (400x).
See this image and copyright information in PMC

References

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