Ciliary Body Mesectodermal Leiomyoma Diagnosed by Fine Needle Aspiration Biopsy.

AIMS: To describe the clinical, imaging, cytopathological, and immunohistochemical features of mesectodermal leiomyoma of the ciliary body diagnosed by fine needle aspiration biopsy in a patient who denied any major intervention without prior pathological verification.

METHODS: The clinical, imaging, and cytopathological records of the patient were retrospectively reviewed. A fine needle aspiration biopsy with a 25-G needle was performed after tailoring a scleral flap.

RESULTS: Examination of the cell blocks prepared from the aspirate demonstrated cells with granular cytoplasms and large nuclei. Immunohistochemical studies showed positive smooth muscle actin, desmin, h-caldesmon, CD56, and neuron-specific enolase stainings, suggesting both neurogenic and myogenic differentiation. Reactions for HMB-45, S-100, panCK, epithelial membrane antigen, glial fibrillary acidic protein, and CD68 were negative. Because the tumor continued to enlarge, fractionated stereotactic radiotherapy at the dose of 3,000 cGy was delivered, which reduced the size of the mass by 40% in 5 years.

CONCLUSIONS: This case demonstrated that the diagnosis of mesectodermal leiomyoma of the ciliary body can be established with fine needle aspiration biopsy and that stereotactic radiotherapy can be successfully used to induce tumor regression.