International Journal of Ophthalmic PathologyISSN: 2324-8599

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Case Report, Int J Ophthalmic Pathol Vol: 3 Issue: 1

Congenital Orbital Teratoma: A Rare Presentation

Ritusha Mishra1, Himanshu Mishra1, Deepak Mishra2* and Pratyush Ranjan2
1Department of Radiotherapy & Cancer Oncology, Institute of Medicine, Benaras Hindu University, varanasi, Uttar Pradesh, India
2Regional Institute of Ophthalmology & Sitapur Eye Hospital, Sitapur, Uttar Pradesh, India
Corresponding author : Dr. Deepak Mishra, MBBS, DNB, MNAMS
Regional Institute of Ophthalmology, Sitapur, Uttar Pradesh, India
E-mail: [email protected]
Received: October 10, 2013 Accepted: March 05, 2014 Published: March 10, 2014
Citation: Deepak Mishra (2014) Congenital Orbital Teratoma: A Rare Presentation . Int J Ophthalmic Pathol 3:1. doi:10.4172/2324-8599.1000129

Abstract

Congenital Orbital Teratoma: A Rare Presentation

We report a very rare case of unilateral congenital orbital teratoma with marked proptosis presenting at birth. Clinical examination and histopathology reports showed the tumor to be confined to the orbit. Considering the size and extent of tumour, an exenteration was done under general anaesthesia.

Keywords: Orbital teratoma; Congenital tumors; Dermoid

Keywords

Orbital teratoma; Congenital tumors; Dermoid

Introduction

Congenital teratomas are mixed tumours arising from the germ layers, and rarely affect the orbit [1]. Teratomas are known to rarely turn malignant and various prognostic factors have been studied [2]. We are reporting a case of Congenital orbital teratoma in a 28 day old female.

Case Report

A full term female infant was born at home by normal, uneventful, unsupervised, vaginal, delivery. The parents, who were farmers by profession, noted a small fleshy mass in place of the right eye at birth and presented to our tertiary care hospital. Patient gives no history of any routine antenatal care.
On examination the girl appeared healthy weighing 2.8 kg, the mass was extra ocular and had blood mixed discharge on its surface, mass was not tender but bleeds to touch (Figure 1). The right eye was not seen instead a large fungating mass was present which was firm to touch and manual reduction of the mass was not possible. The central part had a black keratinized protrusion. It extended up to the forehead superiorly and over the cheek up to the right nasal ala inferiorly. No regional lymph nodes were palpable, the left eye was normal.
Figure 1: Photograph of baby showing congenital proptosis of the right eye.
The haemoglobin and total and differential counts were normal; a CT scan showed an enlarged orbit with the optic nerve being identified. The rectus muscles and the globe appeared to be mixed with a semi calcified mass. MRI showed a mixed cystic-solid orbital mass containing areas of calcification. The superior orbital fissure appeared to be normal. A differential diagnosis of congenital tumors such as teratoma or neurofibroma, dermoid, microphthalmos with cysts were considered.
Considering the size and extent of tumour, an exenteration with reconstruction of the eyelids were done under general anaesthesia. Histology of the tumour showed it to be a mature teratoma. Unfortunately the child was lost to follow up; hence long term post operative results are not known.

Discussion

Ocular mass at birth is uncommon and a teratoma is a rare cause [3]. Orbital teratomas are more common in females than males (2: 1) and have a slight preponderance for the left side [4] whosever our patient have right side involvement. The usual presentation is that of proptosis of the involved eye [5], same in our case. The aim of surgery should be to remove the mass completely because any residual tumour elements will lead to recurrence.

References






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