Orbitoconjunctival Myxoma: A Case Report and a Brief Literature Review

Lixi, Filippo;Cuccu, Alberto;Mangoni, Lorenzo;Tulumello, Claudia;Pilloni, Luca;Timofte-Zorila, Mihaela-Madalina;Giannaccare, Giuseppe

2025-01-01

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Abstract

A 50-year-old male presented with painless swelling in the superonasal sector of his left eye that had appeared a year before and was unresponsive to topical steroids. He had a history of trauma to the affected eye two years prior to presentation. Examination revealed a 1 cm cystic neoformation in the episcleral subconjunctival area near the superonasal orbital margin, with normal ocular motility and no diplopia. Computed tomography (CT) showed a cystic formation between the anterior superomedial orbit and superolateral surface of the medial rectus muscle, without intraconal space involvement. Magnetic resonance imaging (MRI) indicated that the formation was hyperintense on T2 and hypointense on T1, with avid post-contrast enhancement and no extension into the surrounding structures. The neoformation was surgically removed by opening the conjunctiva, isolating the medial rectus muscle, and detaching the mass from uninfiltrated tissues. Histological examination, initially suspected to be a post-traumatic inclusion cyst, revealed an orbitoconjunctival atypical myxoma without signs of malignancy. Complete excision was deemed definitive therapy. Postoperative systemic and cardiac evaluation excluded additional myxomatous lesions. Six months after surgery, the patient remained recurrence-free.