Leiomyomas are exceedingly rare tumors of the orbit and periorbital region. Our objective is to describe the clinical, histopathologic, and radiologic features and the management of 4 cases of orbital leiomyomas and to summarize the cases from the literature.
This retrospective review describes 4 patients with orbital leiomyoma diagnosed by clinical and histopathologic studies. Electron microscopy was performed in 2 cases. Immunohistochemical techniques were performed with 5 monoclonal antibodies. Selected papers describing well-documented cases of orbital leiomyoma in the English literature published since 1960 were reviewed.
CT and MRI showed well-circumscribed contrast-enhancing mass lesions. Three tumors were completely excised and 1 had subtotal excision. All 4 tumors showed immunoreactivity for actin, desmin, and vimentin. Follow-up examination showed no evidence of recurrence in 3 patients. One patient was lost to follow-up.
Leiomyoma should be considered in the differential diagnosis of a well-circumscribed mass lesion involving the orbit and periorbital region. Immunohistochemistry provides conclusive evidence to confirm the diagnosis.