Wide-Excision Choice in Orbital Rhabdomyosarcoma on an 8-Year-Old Patient in a Low-Resource Setting: A Case Report

Rhabdomyosarcoma is the most common neoplasm of skeletal myoblast-like cells in children aged 5-8 years. It typically occurs in the head, neck region, genitourinary tract, retroperitoneum, and extremities.

An 8-year-old boy complained of a lump under his left eye that he had felt for the past 4 years. Initially small, it gradually grew larger although there were no accompanying symptoms of redness, pain, itching, or eye movement disorders, and no history of trauma. Visual acuity in the left eye was measured at 6/15, with pinhole correction improving to 6/6, while the right eye was 6/6. Intraocular pressure in both eyes was 15 mm Hg. Anterior segment examination of the left eye revealed a mass on the lower eyelid with hard consistency, no erythema, no tenderness, with a flat surface, immobility, and all aspects of the conjunctiva, cornea, pupil, and lens appearing normal. A contrast computed tomography scan showed a solid mass measuring 2.1 × 1.9 × 1.9 cm, suggesting a left inferior eyelid mass. The patient underwent surgical excision of the tumor under general anesthesia. Histopathological examination confirmed the diagnosis of embryonal rhabdomyosarcoma. The patient was scheduled for chemotherapy.

Orbital rhabdomyosarcoma typically presents with sudden onset and rapid proptosis, without a history of trauma or respiratory tract infections. The embryonal subtype is the most common and has a better prognosis with combined therapy including surgery, chemotherapy, and radiation. In low-resource settings, early clinical suspicion and thorough physical examination are vital, as limited access to medical tools can complicate management. Treatment should be adapted based on available resources, and regular follow-up is essential to monitor outcomes and ensure optimal care. Any swelling in children should be carefully examined for early detection and effective intervention.