Objective: To analyze the clinical pathologic characteristics of angioleiomyoma of the eyelid and orbit.
Methods: Retrospective case series study. The clinical and pathological characteristics of 8 cases of eyelid and orbital angioleiomyoma which were treated in Tianjin Eye Hospital from January 2005 to April 2014 were reviewed and analyzed.
Results: In the 8 cases, 5 were male and 3 were female. The median age was 52.5 years (32.0 to 65.0). Six cases of angioleiomyoma occurred in the orbit. Three of them located in the muscle cone, 2 of them located in superotemporal orbit and 1 of them located in the inferior orbit. The remaining 2 cases of angioleiomyoma occurred in the medial side of the eyelid subcutanously. Five cases were male and three cases were female. Seven cases revealed a solitary eyelid or orbital mass. One case of orbital angioleiomyoma companied with a cavernous hemangioma of ipsilateral lower eyelid. The color Doppler ultrasound of the orbit showed a well-demarcated mass with homogeneous inner-echoes without obviously blood stream signal. The CT showed a circumscribing rounded or irregular shaped soft mass with isotropic density and the CT value were 45 to 50 Hu. Grossly, the tumor appeared as a rounded or irregular oval ranged from 0.7 to 2.8 cm. Six cases had complete fibrous capsule. Microscopically, the tumor was mainly consisted of well-differentiated smooth muscle cells and thick-walled vessels. Five cases were cavernous type, two cases were venous type and one case was solid type according to histological classification. The smooth muscle cells surrounding the vascular walls and the intervascular muscle bundles showed a positive reaction for smooth muscle actin (SMA) and desmin by immunohistochemical staining. Eight patients underwent complete resection of mass. During the surgery, the tumor was observed with clear boundary and capsule surrounded by mild adhesive tissue.
Conclusions: Angioleiomyoma of the eyelids or orbit was a uncommon benign tumor which was usually occured in adults, with well-encapsulated and composed of numerous thick-walled vessels and smooth muscle components. It should be considered in differential diagnosis of a well-circumscribed orbital mass, and distinguished from leiomyoma or cavernous hemangioma in pathological diagnosis.