Brain Tumor Res Treat.  2019 Oct;7(2):156-159. 10.14791/btrt.2019.7.e30.

Angioleiomyoma in the Orbital Apex: A Case Report

Affiliations
  • 1Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea. euihyunkim@yuhs.ac
  • 2Brain Tumor Center, Severance Hospital, Seoul, Korea.
  • 3Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
  • 4Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.

Abstract

A 56-year woman presented eyeball pain and blurred vision. MRI revealed a small well-delineated solid tumor in the apex of right orbit with optic nerve compression. Intraoperatively, the tumor was found very fibrous, hypervascular and adhesive to surrounding structures. The tumor was completely removed with the combination of endoscopic and microscopic technique. Patient experienced transient oculomotor nerve palsy, which completely recovered 3 months after surgery. Herein we report a rare case of angioleiomyoma in the orbital apex.

Keyword

Angioleiomyoma; Endoscopic surgical procedure; Orbital neoplasms

MeSH Terms

Adhesives
Angiomyoma*
Endoscopy
Female
Humans
Magnetic Resonance Imaging
Oculomotor Nerve Diseases
Optic Nerve
Orbit*
Orbital Neoplasms
Adhesives

Figure

  • Fig. 1 Preoperative MRI and visual field test. A: T1-weighted image shows isointense 13 mm-sized intraconal tumor (white arrow heads) at right orbital apex. B: T1-weighted contrast enhanced image shows homogeneous enhancement of the tumor (white arrow heads). C: T2-weighted coronal image shows that the tumor (white arrow heads) is located at innermost of the orbital apex with superomedial compression of the right optic nerve (a white arrow). D: Visual field test reveals the patient could see only the bottom half of her right eye.

  • Fig. 2 Histopathological examination. A: In low power view (H–E ×12), a well demarcated soft tissue mass with many vascular channels are seen. B and C: In middle power view, smooth muscle cell proliferation (smooth muscle actin ×100) with myxoid stroma surrounding vascular channel are noted (H–E ×100).

  • Fig. 3 Postoperative MRI and visual field test. A and B: T1-wighted image (A) and T1-weighted contrast enhanced image (B) shows that the tumor was totally resected. C: T2-weighted coronal image shows that the optic nerve is decompressed (a white arrow). D: Visual field test revealed that patient's right visual field defect was completely recovered one year after the surgery.


Reference

1. Ramesh P, Annapureddy SR, Khan F, Sutaria PD. Angioleiomyoma: a clinical, pathological and radiological review. Int J Clin Pract. 2004; 58:587–591. PMID: 15311559.
Article
2. Conner TM, Waziri A, Kleinschmidt-Demasters BK. Angioleiomyomas of the dura: rare entities that lack KRIT1 mutations. Am J Surg Pathol. 2012; 36:526–533. PMID: 22261708.
3. Arat YO, Font RL, Chaudhry IA, Boniuk M. Leiomyoma of the orbit and periocular region: a clinicopathologic study of four cases. Ophthalmic Plast Reconstr Surg. 2005; 21:16–22. PMID: 15677948.
4. Jakobiec FA, Zakka FR, Papakostas TD, Fay A. Angiomyofibroma of the orbit: a hybrid of vascular leiomyoma and cavernous hemangioma. Ophthalmic Plast Reconstr Surg. 2012; 28:438–445. PMID: 23138203.
5. Jakobiec FA, Zakka FR, Yoon MK. Complex orbital angiomyoma with features of a lymphangiohemangioma. Ophthalmic Plast Reconstr Surg. 2013; 29:e61–e65. PMID: 23235513.
Article
6. Alam MS, Subramanian N, Koka K, Subramanian K. Orbital angioleiomyoma: a rare orbital neoplasm. Orbit. 2016; 35:113–116. PMID: 26927953.
Article
7. Nair AG, Jain V, Gopinathan I, Murthy A. Solid variant of orbital angioleiomyoma: an unusual tumor at an unusual site. Indian J Ophthalmol. 2016; 64:466–468. PMID: 27488159.
Article
8. Sato K, Ogawa Y, Kinoshita K, et al. [A case of an orbital angioleiomyoma]. No Shinkei Geka. 2017; 45:1087–1092. PMID: 29262390.
9. Gasco J, Franklin B, Rangel-Castilla L, Campbell GA, Eltorky M, Salinas P. Infratentorial angioleiomyoma: a new location for a rare neoplastic entity. J Neurosurg. 2009; 110:670–674. PMID: 19012476.
Article
10. Hachisuga T, Hashimoto H, Enjoji M. Angioleiomyoma. A clinicopathologic reappraisal of 562 cases. Cancer. 1984; 54:126–130. PMID: 6722737.
Article
11. Li D, Hao SY, Tang J, et al. Primary intracranial angioleiomyomas: diagnosis, treatment, and literature review. Brain Tumor Pathol. 2014; 31:101–107. PMID: 23661286.
Article
12. Jakobiec FA, Howard GM, Rosen M, Wolff M. Leiomyoma and leiomyosarcoma of the orbit. Am J Ophthalmol. 1975; 80:1028–1042. PMID: 1200096.
Article
13. Delgado-Fernandez J, Penanes JR, Torres CV, Gordillo-Velez CH, Manzanares-Soler R, Sola RG. Infratentorial angioleiomyoma: case report and review of the literature. Rev Neurol. 2016; 62:68–74. PMID: 26758353.
14. Sun L, Zhu Y, Wang H. Angioleiomyoma, a rare intracranial tumor: 3 case report and a literature review. World J Surg Oncol. 2014; 12:216. PMID: 25027207.
Article
15. Li CB, Xie MG, Ma JP, et al. Primary intracranial angioleiomyomas as rare, nonmalignant, and distinct neoplastic entities: a series of 8 cases and a literature review. World Neurosurg. 2018; 113:1–13. PMID: 29425983.
Article
16. Berhouma M, Jacquesson T, Abouaf L, Vighetto A, Jouanneau E. Endoscopic endonasal optic nerve and orbital apex decompression for nontraumatic optic neuropathy: surgical nuances and review of the literature. Neurosurg Focus. 2014; 37:E19.
Article
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