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Updated: Jul 9, 2026
Anterior High-Resolution Optical Coherence Tomography in the Diagnosis and Therapeutic Monitoring of Ocular Surface Squamous Neoplasia
Published on: August 9, 2024
Squamous cell carcinoma presenting as an orbital cyst with radiologic evidence of perineural invasion
V Limawararut1, E Hoyama, D Selva
1Oculoplastic and Orbital Division, Department of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, Australia.
Purpose:
To report clinical and radiologic findings of cystic squamous cell carcinoma (SCC) of the orbit with evidence of perineural involvement.
Methods:
Analysis of clinical findings and radiology with a literature review.
Results:
A 66-year-old man with SCC of the forehead 8 years prior presented with paraesthesias, diplopia, and proptosis. Magnetic resonance imaging showed a well-defined, cystic mass of the orbit with a single, linear structure running through its center. Lateral orbitotomy revealed a cyst adherent to adjacent periorbita containing viscous, clear, yellow substance and a nerve coursing through the center. Histopathology confirmed poorly differentiated spindle cell carcinoma with positive staining for cytokeratin markers, consistent with SCC.
Conclusions:
Orbital cysts associated with altered sensation are suggestive of SCC with perineural spread, requiring prompt investigation and treatment to minimize morbidity and mortality. The involved nerve may be seen as a single, linear structure within the mass on imaging.
