Primary orbital liposarcoma misdiagnosed as thyroid associated orbitopathy

Area of Science:

• Ophthalmology
• Oncology
• Pathology

Background:

• Orbital malignancies can present with signs overlapping those of thyroid-associated orbitopathy (TAO).
• Clinical and radiographic findings such as proptosis, extraocular muscle (EOM) enlargement, and EOM restriction can be shared between these conditions.
• Accurate diagnosis is crucial as treatment and prognosis differ significantly.

Observation:

• A case is presented where a primary orbital liposarcoma mimicked TAO.
• The patient exhibited proptosis, EOM enlargement on imaging, and EOM restriction leading to diplopia.
• These clinical features initially suggested TAO.

Findings:

• Histopathological examination confirmed the diagnosis of primary orbital liposarcoma.
• The liposarcoma presented as a distinct orbital mass.
• The tumor's characteristics were consistent with a rare orbital malignancy.

Implications:

• This case underscores the diagnostic challenge posed by orbital malignancies mimicking TAO.
• Awareness of such mimicry is essential for appropriate patient management.
• Surgical intervention, including exenteration in this case, may be necessary for managing advanced orbital tumors.