A 35-year-old woman had a large subconjunctival swelling in her right eye (Figure 1). Prominent conjunctival vessels were first noticed during her pregnancy 10 months earlier. A firm elastic mass was palpated. Funduscopy showed an inferomedial indentation. Visual acuity was 20/20. Ultrasonography showed a well-circumscribed tumor with peripheral vascularization. Orbital magnetic resonance imaging showed an anterior soft tissue mass that was hypointense to isointense on both T1- and T2-weighted sequences (Figure 2). Gadolinium-enhanced sequences showed homogeneous filling that was isointense relative to muscle. With a transconjunctival approach, the tumor was dissected free from the medial rectus muscle and excised completely (Figure 3). Histopathological examination revealed a typical leiomyoma (Figure 4). The postoperative course was uneventful, and there was no recurrence in 16 months of follow-up.
van den Broek PP, de Faber JHN, Kliffen M, Paridaens D. Anterior Orbital Leiomyoma. Arch Ophthalmol. 2005;123(11):1614. doi:10.1001/archopht.123.11.1614