Ciliary Body Leiomyoma: Case Report

Abstract

Introduction Leiomyoma is one of the most common pelvic neoplasm in women. It is a noncancerous tumour arising from the smooth muscle cells, usually found in uterus, mainly during women productive years (1). However, intraocular leiomyomae are rare and usually occur in the anterior part of the uvea and can appear as a dome-shaped, nonpigmented, smooth and solid structures (2-4). Although it is a benign tumour, it can be destructive to ocular structures (2). Case Presentation A ciliary body mass was observed in a 43-year-old woman during left eye cataract surgery in 2020. Prior patient was diagnosed with endometriosis and multiple leiomyomas in oesophagus, vulva and cervix, which were operated in 2013, and in 2017. An oval mass with well-defined edges, measuring 7.28/9.00 mm was found during LE ultrasound. Ultrasound biomicroscopy (UBM) showed a circumferential solid ciliary tumour in both eyes: in the left eye (height)1.5-2.5 mm, and right – 2.5 mm. Magnetic resonance imaging (MRI) showed changes in ciliary body muscle, uneven contrast medium absorption in the thickening of soft tissues – supralateral 0.5 cm, on the right medial side 0.8 cm size. Clinical diagnosis – circumferential ciliary body leiomyoma in both eyes. It was recommended to examine other body systems for possible neoplastic formations. Repeated UBM from February of 2021 to May of 2024 showed: intraocular tumours without dynamic changes. Secondary cataract was diagnosed in both eyes, and as the tumour growth was not detected, it was treated with Nd YAG laser. Current follow up is once yearly. The patient is currently under gynaecologists supervision for genitourinary tract tumours. Discussion This clinical case shows the risk factors and symptoms of ciliary body leiomyoma and the importance of progress tracking. Although leiomyoma is a benign mass, it can cause vision problems, retinal detachment or other ocular complications, caused not by malignancy, but by the size and the localization in the eye (2). Constant follow up and timely response are necessary for treatment. Conclusions Ciliary body leiomyoma, a smooth muscle tumour, although benign, can cause vision dysfunction and complications. For that reason diagnostics, monitoring and treatment are crucial. Constant follow up and timely response are necessary for treatment.