A Rare Case of Primitive Epithelioid Leiomyosarcoma of the Conjunctiva

Purpose: To describe a rare case of conjunctival leiomyosarcoma initially diagnosed as a poorly differentiated squamous cell carcinoma. Methods: Clinical, light microscopic, immunohistochemical, and ultrastructural findings are reported. Results: A 56-year-old Caucasian woman was referred with a his...

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Bibliographic Details
Published in:Orbit (Amsterdam) 2011-06, Vol.30 (3), p.169-171
Main Authors: Guerriero, Silvana, Sborgia, Alessandra, Giancipoli, Giovanni, Fiore, Maria Grazia, Ross, MD, Roberta, Piscitelli, MD, Domenico
Format: Article
Language:English
Subjects:
Biopsy, Needle
Chemotherapy, Adjuvant
Combined Modality Therapy
Conjunctival Neoplasms - diagnosis
Conjunctival Neoplasms - pathology
Conjunctival Neoplasms - therapy
Eye Enucleation - methods
Female
Follow-Up Studies
Humans
Immunohistochemistry
Leiomyosarcoma - diagnosis
Leiomyosarcoma - pathology
Leiomyosarcoma - therapy
Magnetic Resonance Imaging - methods
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Radiotherapy, Adjuvant
Rare Diseases
Tomography, X-Ray Computed
Treatment Outcome
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Summary:Purpose: To describe a rare case of conjunctival leiomyosarcoma initially diagnosed as a poorly differentiated squamous cell carcinoma. Methods: Clinical, light microscopic, immunohistochemical, and ultrastructural findings are reported. Results: A 56-year-old Caucasian woman was referred with a history of a progressive, rapidly growing mass in her left eye. Biopsy of the mass and histology yielded a first diagnosis of a poorly differentiated conjunctival squamous cell carcinoma. Orbital exenteration was performed 2 weeks later. Macroscopically, the exenteration specimen showed a soft mass completely involving the conjunctiva and extending to the eyelids and orbital structures. Histological examination revealed a malignant tumour composed of atypical, predominantly epithelioid large cells. Immunohistochemical and ultrastructural studies combined with the light microscopic findings contributed to clarify the diagnosis of epithelioid leiomyosarcoma. The patient was started on chemotherapy and radiotherapy, but died a few months later from widespread metastases. Conclusions: primary involvement of the orbit by a leiomyosarcoma is rare, but this eventuality should be considered in the differential diagnosis of rapidly growing orbital and conjunctival masses.
ISSN:0167-6830
1744-5108
DOI:10.3109/01676830.2011.574771