ABSTRACT
A 35-year-old Caucasian female patient, with previous recession of the IO and LR muscles for exotropia and elevation in adduction with V-pattern, presented a painless vascular conjunctival lesion and recurrent exotropia with limitation of adduction (Fig. 1). She had first noticed the lesion during her pregnancy ten months earlier. On examination there was a large, round, subconjunctival swelling with prominent overlying vessels, a superotemporal translation of the right bulbus and minimal proptosis. Best corrected visual acuity was 20/20 in both eyes. Fundoscopy showed an inferomedial indentation of the right eye. MR-imaging showed an extraconal oval soft tissue mass, inferomedial to the bulbus in the anterior right orbit (Fig. 2). A large yellow-white tumour (23 15 10 mm) was dissected free from its attachment to the medial rectus muscle via a transconjunctival incision. Histopathological and immunohistochemical examination showed the characteristic picture of a benign smooth muscle tumour: leiomyoma. Postoperatively the patient had normal eye motility and visual acuity.
