An unusual presentation of alveolar type of rhabdomyosarcoma of orbit

Orbital rhabdomyosarcoma is the commonest primary orbital malignancy in children. A case of alveolar type of orbital rhabdomyosarcoma with unusual presentation in a three and half years male child presented with painless nodular swelling in the left lower lid of one and half years duration and gradual protrusion of the left eyeball. Examination of the patient revealed a mass in the left lower lid region extending to other parts of orbit and lymphnode metastasis in the neck region along with non axial proptosis, rest of the systemic examination being normal. Patient underwent incisional biopsy of the mass and excisional biopsy of the lymphnodes which revealed alveolar type of primary orbital rhabdomyosarcoma with lymphnode metastasis.