Intraconal Orbital Angioleiomyoma: A Case Report and Review of Literature

To present a patient with interaconal orbital angioleiomyoma.

A 22-year-old woman presented with painless slowly progressive proptosis. CT and MRI demonstrated a well-defined Interaconal globe size mass (inferomedially). It was isointense in T1 and T2 weighted and homogenously enhanced by Gadolinium. During the surgery, the tumor was excised via a lateral orbitotomy approach; significant hemorrhage and adhesions to surrounding tissues were noticeable. Histopathologic analysis of the specimen revealed smooth muscle cells with vascular components. IHC assay was positive for SMA and CD34, which confirmed the diagnosis of angioleiomyoma. The patient recovered uneventfully and one year of follow-up showed no recurrence or complications.

ALM is an uncommon benign smooth muscle tumor with a vascular component. Orbital involvement (especially interaconal) is extremely rare; caution about considerable intraoperative bleeding and adhesions to surrounding tissue is recommended.