నైరూప్య

Smooth muscle hamartoma in lateral canthus simulating lipodermoid: A rare entity

Mousumi Banerjee

Smooth muscle hamartoma (SMH) is a rarely encountered neoplasm with only 2 reported cases of SMH involving conjunctival fornix. The similarity in the location, appearance and radioimaging features of the lesion with lipodermoid in our case point towards the difficulty in diagnosing SMH clinically.

A 16 year old male presented with a 12 mm × 5 mm pinkish yellow, non-tender lesion in temporal fornix with extension to superior and inferior fornices. No hair follicle was observed on its surface. There was no variation in the size of the lesion with valsalva/bending down/straining efforts. Local excision of the lesion was planned and sent for histopathological examination.

CECT brain and orbit revealed a well-defined mass in lateral part of sclera in left eye with fatty attenuation, with no post septal extension/erosions of adjacent bones/calcification/intracranial extension suggestive of lipodermoid. Histopathology report of excised lateral canthal mass revealed lobulated fat with vascularised fibrous tissue and smooth muscle suggestive of a hamartoma.