Conjunctival leiomyoma; a rare tumor of the ocular surface
An 18-year-old girl presented to the outpatient department complaining of a conjunctival mass in her left eye, which was stable in size for the past 2 years and was not associated with irritation or bleeding. Past history was unremarkable regarding ocular trauma, surgery, or infection. The patient merely presented for cosmetic reasons. Examination revealed visual acuity of 20/20 in both eyes. The left eye had a sessile, nodular conjunctival growth which seemed to be originating from the plica semilunaris and extending towards the nasal limbus. It had prominent blood vessels and was not adherent to the sclera. The rest of the ocular examination was unremarkable in both eyes. There was no complaint of diplopia; the extra ocular movements were full in all directions in both eyes. The conjunctival growth looked like a benign lesion. She was scheduled for excisional biopsy. The tough and vascular tissue was excised and sent for histopathology and the defect was covered by an end to end conjunctival suturing. Histopathology revealed the lesion to be a leiomyoma. On the cut section, the stroma was collagenous and the lesion had spindle shaped cells in a storiform arrangement. The spindle cells had elongated cigar shaped nuclei, clumped chromatin and scanty cytoplasm. Trichome was used to highlight the spindle shaped cells and immuno-histochemistry using anti-smooth muscle actin antibody and Vimentin was done to confirm the diagnosis. Mitosis and atypia were not seen in the lesion.

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