Report of a conjunctival myxoma case and review of the literature.

Myxoma is a benign soft tissue tumor that presumably derives from primitive mesenchyme. It is characterized histopathologically by abundant mucoid material, a loose meshwork of reticulin fibers, and relatively small numbers of spindleand stellate-shaped cells. The stromal matrix is rich in glucosaminoglycans and hyaluronic acid, and it is sparse in collagen and vascular structures. Myxoma can appear as localized disease or as a component of Carney complex, which includes cutaneous and cardiac myxomas, multiple pigmented lesions, and endocrine overactivity, leading to significant morbidity and mortality. Myxoma is the most common primary cardiac tumor. This tumor can arise in the skeletal muscle, bone, skin, genitourinary system, gastrointestinal tract, and nasal sinuses. It can rarely involve ocular structures and has been recognized in the eyelid, orbit, and conjunctiva. In a review of 2455 conjunctival lesions submitted to an ophthalmic pathology laboratory, only 4 patients (0.002%) were found to have conjunctival myxoma. In a clinical review of 1643 patients with conjunctival lesions, myxoma was found in 1 case ( 0.001%). Because of its rarity, conjunctival myxoma can simulate other conjunctival tumors, such asamelanoticnevus, amelanoticmelanoma, squamous cell carcinoma, lipoma, and cyst. We describe a 31-year-old African American man who had a yellow, translucent subconjunctival mass that proved to be a conjunctival myxoma on histopathological examination.