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A Horrific Case of Proptosis: Salvaging Vision in a Pediatric Patient With Rapidly Growing Orbital Rhabdomyosarcoma
Kunalini Anpalagan1,2,3, Christine Ong3, Siu Wan Foo3
1Department of Ophthalmology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS.
Insights
A rapidly growing orbital mass in a child, initially misdiagnosed as a chalazion, was identified as embryonal rhabdomyosarcoma. Prompt biopsy and multimodal treatment are crucial for favorable outcomes in pediatric orbital tumors.
Area of Science:
- Ophthalmology
- Pediatric Oncology
- Pathology
Background:
- Orbital masses in children can present with varied symptoms, sometimes mimicking benign conditions like chalazion.
- Rapidly progressing orbital tumors pose diagnostic challenges and risk significant vision loss.
- Embryonal rhabdomyosarcoma is a rare but aggressive soft tissue sarcoma that can occur in the orbit.
Abstract:
We report the case of a four-year-old male who presented with painless right upper eyelid swelling initially treated as a chalazion. The swelling rapidly progressed within two weeks, resulting in non-axial proptosis, thereby restricting ocular motility and causing vision loss. Imaging revealed a large superomedial orbital mass with optic nerve displacement. Histopathology confirmed embryonal rhabdomyosarcoma (RMS) group III. This report highlights the importance of prompt biopsy, multidisciplinary care, and a multimodal approach in achieving favorable outcomes through early diagnosis and intervention despite rapid tumor growth and optic nerve involvement.
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