Park Seong Hwan, Lee Ji-Hye, Chae Yang Seok, Kim Chul Hwan
Department of Pathology, College of Medicine, Korea University, Seoul, Korea.
J Korean Med Sci. 2003 Aug;18(4):614-7. doi: 10.3346/jkms.2003.18.4.614.
A 19-yr-old woman with a previous history of a mass of the right ciliary body presented with a decreased visual acuity of right eye. Clinicoradiologic examinations suggested a recurrent mass of the ciliary body. Enucleation of the right eye was performed under the impression of malignant tumor. On microscopic examination, the tumor was a mesectodermal leiomyoma of the ciliary body. On immunohistochemistry, the tumor cells were reactive to smooth muscle actin and vimentin, but not reactive to cytokeratin, S-100 protein, neurofilament, desmin, epithelial membrane antigen, HMB-45, glial fibrillary acidic protein, and synaptophysin. Electron microscopy revealed numerous thin longitudinally placed myofilaments and focal densities in the cytoplasms. In the review of the literature, only 27 cases of mesectodermal leiomyoma of the ciliary body were reported, however, there was no report of recurrent cases. Mesectodermal leiomyoma should be differentiated from other orbital spindle-cell tumors such as amelanotic melanomas and glial tumors. Immunohistochemical and electron microscopic studies may be useful for the correct diagnosis by showing smooth muscle differentiation in the tumor cells.
一名19岁女性，既往有右睫状体肿物病史，此次因右眼视力下降就诊。临床影像学检查提示睫状体肿物复发。在怀疑为恶性肿瘤的情况下，行右眼眼球摘除术。显微镜检查显示，肿瘤为睫状体中胚层平滑肌瘤。免疫组化检查显示，肿瘤细胞对平滑肌肌动蛋白和波形蛋白呈阳性反应，但对细胞角蛋白、S-100蛋白、神经丝、结蛋白、上皮膜抗原、HMB-45、胶质纤维酸性蛋白和突触素呈阴性反应。电子显微镜检查显示，细胞质内有许多纵向排列的细肌丝和局灶性致密物。文献复习显示，仅报道过27例睫状体中胚层平滑肌瘤，然而，尚无复发病例的报道。中胚层平滑肌瘤应与其他眼眶梭形细胞瘤，如无色素性黑色素瘤和神经胶质瘤相鉴别。免疫组化和电子显微镜检查通过显示肿瘤细胞的平滑肌分化，可能有助于正确诊断。
