eMedicine Specialties > Ophthalmology > Iris & Ciliary Body

Leiomyoma, Iris

Author: Manolette R Roque, MD, MBA, DPBO, FPAO, President and CEO, Chief of Service, Ocular Immunology and Uveitis, Consulting Staff, Cornea and Refractive Surgery, Eye Republic Ophthalmology Clinic; General Manager, Ophthalmic Consultants Philippines Co; Consulting Staff, CME Liaison, Section Chief of Ocular Immunology and Uveitis, Department of Ophthalmology, Asian Hospital and Medical Center
Coauthor(s): Barbara L Roque, MD, Full Partner, Ophthalmic Consultants Philippines Co, Chief of Service, Pediatric Ophthalmology and Strabismus, Consulting Staff, Orbit and Eye Plastics, EYE REPUBLIC Ophthalmology Clinic; C Stephen Foster, MD, FACS, FACR, FAAO, Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institute
Contributor Information and Disclosures

Updated: Dec 27, 2007

Introduction

Background

Leiomyoma of the iris is a rare, benign intraocular smooth muscle tumor. The tumor often originates from the sphincter or less commonly from the dilator muscles. Studies have found that leiomyomas occur much less frequently than previously reported. It is believed strongly that iris leiomyoma has been previously overdiagnosed. Stricter diagnostic criteria involving electron microscopy and immunohistopathology have been added as standards for reporting.

Pathophysiology

Uncertainty to the pathogenesis of iris leiomyoma exists. Hormones are speculated to play a role in the pathogenesis due to the tumor's similarity to uterine leiomyoma (fibroids) and its predilection to females. Structures in the iris of neuroectodermal origin believed to give rise to the tumor include the sphincter muscle and the dilator muscle. Structures in the iris of mesodermal origin believed to give rise to the tumor include mesenchymal tissue.

Frequency

United States

The incidence of smooth muscle tumors has been reported as 2.3%, 4%, 9%, and 14.5%, in different published series of iris tumors.

Mortality/Morbidity

No reported data on mortality and morbidity from iris leiomyoma exist. Morbidity may be limited to the occasional presence of secondary glaucoma and decreased vision when the mass reaches the visual axis.

Race

This condition is reported only in white subjects.

Sex

Females are affected more frequently than males.

Age

Cases of leiomyoma of the iris have been seen in patients aged 10-77 years.

Clinical

History

This tumor is usually a benign iris mass that remains clinically stationary for many years. See Physical.

Physical

  • Leiomyoma of the iris is a localized, flat to slightly elevated mass, often at the region of the sphincter muscle. It is found less commonly in the iris periphery and the anterior chamber angle.
  • Clinically, the tumor appears nonpigmented (sometimes lightly pigmented), transparent (grayish white to pink colored), and vascular.
  • Ectropion iridis is a common finding in the area of the tumor.
  • Leiomyoma of the iris may be difficult to differentiate from an amelanotic iris melanoma.
  • These tumors can be clinically stationary for many years.

Causes

The cause of leiomyoma of the iris is unknown. See Pathophysiology.

More on Leiomyoma, Iris

Overview: Leiomyoma, Iris
Differential Diagnoses & Workup: Leiomyoma, Iris
Treatment & Medication: Leiomyoma, Iris
Follow-up: Leiomyoma, Iris
Multimedia: Leiomyoma, Iris
References
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References

  1. Ashton N, Wybar K. Primary tumours of the iris. Ophthalmologica. 1966;151(1):97-113. [Medline].

  2. Biswas J, Kumar SK, Gopal L, Bhende MP. Leiomyoma of the ciliary body extending to the anterior chamber: clinicopathologic and ultrasound biomicroscopic correlation. Surv Ophthalmol. Jan-Feb 2000;44(4):336-42. [Medline].

  3. Brovkina AF, Chichua AG. Value of fluorescein iridography in diagnosis of tumours of the iridociliary zone. Br J Ophthalmol. Mar 1979;63(3):157-60. [Medline].

  4. Campbell RJ, Min KW, Bolling JP. Skeinoid fibers in mesectodermal leiomyoma of the ciliary body. Ultrastruct Pathol. Nov-Dec 1997;21(6):559-67. [Medline].

  5. De Buen S, Olivares ML, Charlín C. Leiomyoma of the iris. Report of a case. Br J Ophthalmol. May 1971;55(5):353-6. [Medline].

  6. Eide N, Farstad IN, Røger M. A leiomyoma of the iris documented by immunohistochemistry and electron microscopy. Acta Ophthalmol Scand. Aug 1997;75(4):470-3. [Medline].

  7. Foss AJ, Pecorella I, Alexander RA, Hungerford JL, Garner A. Are most intraocular "leiomyomas" really melanocytic lesions?. Ophthalmology. May 1994;101(5):919-24. [Medline].

  8. Ishigooka H, Yamabe H, Kobashi Y, Nagata M. Clinical and pathological status of mesectodermal leiomyoma of the ciliary body. A case report and review of the literature. Graefes Arch Clin Exp Ophthalmol. 1989;227(2):101-5. [Medline].

  9. Jellie HG, Gonder JR, Willis NR, Green L, Tokarewicz AC. Leiomyoma of the iris. Can J Ophthalmol. Jun 1989;24(4):169-71. [Medline].

  10. Li ZY, Tso MO, Sugar J. Leiomyoepithelioma of iris pigment epithelium. Arch Ophthalmol. Jun 1987;105(6):819-24. [Medline].

  11. Lowe RF, Greer CH. Benign epithelioma of the iris. A clinico-pathological case report. Br J Ophthalmol. Nov 1971;55(11):773-6. [Medline].

  12. Noor Sunba MS, Rahi AH, Garner A, Alexander RA, Morgan G. Tumours of the anterior uvea. III. Oxytalan fibres in the differential diagnosis of leiomyoma and malignant melanoma of the iris. Br J Ophthalmol. Nov 1980;64(11):867-74. [Medline].

  13. Okamoto N, Sotani T, Shimo-Oku M, Sashikata T. A case with leiomyoma of iris extirpated with cryosurgery and its pathological findings. Acta Ophthalmol (Copenh). Apr 1982;60(2):183-9. [Medline].

  14. Orsoni JG, Daicker B, Cardillo Piccolino F. Mesectodermal leiomyoma of the ciliary body extending into the anterior chamber. Ophthalmologica. 1985;191(2):127-9. [Medline].

  15. Palm E, Linder B. Excision of tumours in the iris and the ciliary body. Acta Ophthalmol (Copenh). 1968;46(3):521-8. [Medline].

  16. Peyman GA, Alghadyan A, Peace JH. A contact Nd:YAG laser to resect large ciliary body and choroidal tumors. Int Ophthalmol. Oct 1987;11(1):55-61. [Medline].

  17. Price MJ, Bell RA, Willis WE, Whiteman DW. Tapioca melanoma of the iris: clinicopathological correlation with results of fluorescein angiography. Can J Ophthalmol. Oct 1981;16(4):195-9. [Medline].

  18. Sevel D, Tobias B. The value of fluorescein iridography with lleiomyoma of the iris. Am J Ophthalmol. Sep 1972;74(3):475-8. [Medline].

  19. Shields JA, Sanborn GE, Augsburger JJ. The differential diagnosis of malignant melanoma of the iris. A clinical study of 200 patients. Ophthalmology. Jun 1983;90(6):716-20. [Medline].

  20. Tuncer S, Peksayar G, Demiryont M, Gozum N. Longterm follow-up of a patient with iris leiomyoma treated with partial lamellar iridocyclectomy. Acta Ophthalmol Scand. Feb 2004;82(1):112-4. [Medline].

  21. Yu DY, Cohen SB, Peyman G, Tso MO. Mesectodermal leiomyoma of the ciliary body: new evidence for neural crest origin. J Pediatr Ophthalmol Strabismus. Nov-Dec 1990;27(6):317-21. [Medline].

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Further Reading

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Keywords

iris leiomyoma, leiomyoma of the iris, benign intraocular smooth muscle tumor

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Contributor Information and Disclosures

Author

Manolette R Roque, MD, MBA, DPBO, FPAO, President and CEO, Chief of Service, Ocular Immunology and Uveitis, Consulting Staff, Cornea and Refractive Surgery, Eye Republic Ophthalmology Clinic; General Manager, Ophthalmic Consultants Philippines Co; Consulting Staff, CME Liaison, Section Chief of Ocular Immunology and Uveitis, Department of Ophthalmology, Asian Hospital and Medical Center
Manolette R Roque, MD, MBA, DPBO, FPAO is a member of the following medical societies: American Academy of Ophthalmic Executives, American Society of Cataract and Refractive Surgery, American Society of Ophthalmic Administrators, American Uveitis Society, International Ocular Inflammation Society, Philippine Medical Association, Philippine Ocular Inflammation Society, and Philippine Society of Cataract and Refractive Surgery
Disclosure: Nothing to disclose.

Coauthor(s)

Barbara L Roque, MD, Full Partner, Ophthalmic Consultants Philippines Co, Chief of Service, Pediatric Ophthalmology and Strabismus, Consulting Staff, Orbit and Eye Plastics, EYE REPUBLIC Ophthalmology Clinic
Disclosure: Nothing to disclose.

C Stephen Foster, MD, FACS, FACR, FAAO, Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institute
C Stephen Foster, MD, FACS, FACR, FAAO is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Association of Immunologists, American College of Rheumatology, American College of Surgeons, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, American Uveitis Society, Association for Research in Vision and Ophthalmology, Massachusetts Medical Society, Royal Society of Medicine, Sigma Xi, and Washington State Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Brian A Phillpotts, MD, Former Vitreo-Retinal Service Director, Former Program Director, Clinical Assistant Professor, Department of Ophthalmology, Howard University College of Medicine
Brian A Phillpotts, MD is a member of the following medical societies: American Academy of Ophthalmology, American Diabetes Association, American Medical Association, and National Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Christopher J Rapuano, MD, Professor, Department of Ophthalmology, Jefferson Medical College; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Hospital
Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, Eye Bank Association of America, Pennsylvania Medical Society, and Philadelphia County Medical Society
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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