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Case Report: Mature congenital teratoma masquerading as orbital cellulitis in a 12-day-old infant
Alyssa C Huelsbeck1, Colin P Froines2, Suzanne W van Landingham2
1School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States.
Insights
Congenital orbital teratoma, a rare newborn tumor causing eye proptosis, requires prompt surgical removal. Early diagnosis and excision lead to excellent survival rates, though visual prognosis varies.
Area of Science:
- Ophthalmology
- Pediatric Oncology
- Surgical Pathology
Background:
- Congenital orbital teratoma is a rare neoplasm presenting as unilateral proptosis in newborns.
- Management involves surgical excision, with guarded visual prognosis but excellent survival.
Background:
Congenital orbital teratoma is a rare neoplasm that typically presents as progressive, unilateral proptosis in an otherwise healthy newborn. Management includes prompt surgical excision, with guarded visual prognosis but excellent survival.
Case Presentation:
A 12-day-old healthy infant presented with progressive left eye swelling and proptosis. She was initially diagnosed with orbital cellulitis and treated with IV antibiotics. Magnetic resonance imaging (MRI) showed a 1.5x1.9x2.1 cm left intraconal mass with 9mm of proptosis and significant mass effect. The patient underwent left lateral orbitotomy for biopsy and excision of the mass. Histopathologic examination showed neutrophilic inflammation and granulation tissue with foci of gastrointestinal epithelium, cartilage, squamous epithelium, and ganglion cells, consistent with mature congenital teratoma. The postoperative course was uncomplicated and there is no sign of recurrence at 21 months of age.
Conclusion:
Orbital teratoma should be suspected in a rapidly growing orbital mass in a newborn. Imaging showing characteristic findings should lead to prompt excisional biopsy. Tumor markers can be used to monitor for recurrence, which is rare.
