Clinicopathological analysis of 34 cases of extraocular muscle space-occupying lesions.

To investigate the clinicopathological characteristics and prognosis of extraocular muscle space-occupying lesions. A retrospective study was conducted on 34 patients with pathologically confirmed extraocular muscle space-occupying lesions who underwent ophthalmic surgery at West China Hospital of Sichuan University between January 2010 and December 2024. Clinical data, including demographic characteristics, clinical presentations, imaging features, pathological diagnoses, treatment regimens, and prognosis, were collected and systematically analyzed. Among the 34 patients, 18 were male and 16 were female, with ages ranging from 7 to 78 years (mean age: 48.2 ± 12.5 years). The main clinical manifestations included proptosis (70.6%, 24/34), decreased ocular motility (DOM) (32.4%, 11/34), and eyelid swelling (32.4%, 11/34). The predominant pathological types were inflammatory pseudotumor (38.2%, 13/34; including 5 sclerosing subtype and 8 mixed subtype), hemangioma (20.6%, 7/34), and mucosa-associated lymphoid tissue (MALT) lymphoma (17.6%, 6/34). The lateral rectus muscle was the most frequently involved site (38.2%, 13/34). The primary treatment modalities were surgery combined with glucocorticoids (47.1%, 16/34) or radiotherapy (29.4%, 10/34). Following treatment, 20.6% (7/34) of patients showed significant symptomatic improvement, 44.1% (15/34) achieved stable disease, and 26.5% (9/34) reached complete response. The main pathological types of extraocular muscle space-occupying lesions are inflammatory pseudotumor (sclerosing and mixed subtypes), hemangioma, and MALT lymphoma, with the lateral rectus muscle being most commonly affected. Standardized treatment can lead to favorable clinical outcomes in the majority of patients.