The importance of the study of proptosis in children

Andreas Paulo Di Luciano, Thomas Johnson, María Montero Romero

Resumen


A 15-year-old boy presented with history of a previous orbitotomy due to an ethmoidal osteoma on his right side, painless progressive protrusion of the right eye (RE) for 6 months. No history of trauma. Nor-mal development and no past family history.

His visual acuity was RE 20/80 and LE 20/20. Pupils were reactive in both eyes. Right proptosis of 25 mm with restriction of the ocular motility superiorly, inferiorly, laterally and medially.Mild conjunctival che-mosis and lateral eye displacement (Figure 1A).

Laboratory investigations showed an erythrocyte sedimentation rate of 50 mm/h,

the rest of the tests were normal.

An MRI was done, fi nding the following: heterogeneously enhancing of the mass in the right retro-orbital space pushing the eyeball anteriorly and displaced the optic nerve laterally. Sclerosis of the adjacent eth-moid bone but no frank destruction was seen. No extension of the mass into intracraneal cavity. Left eye was normal. (Figure 1B).

The presumptive diagnosis was tumor recurrence of primary Osteoma vs Rhabdomyosarcoma in the RE.

Given the clinical and imaging characteristics, the size of the mass and the compromise of the ocular structures, it was decided to perform a biopsy by excision under general anesthesia in the compromised eye.


Palabras clave


proptosis;rhabdomyosarcoma; osteoma

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Referencias


Jurdy L, Merks JH, Pieters BR, et al. Orbital rhabdomyosarcomas: A review. Saudi J Ophthalmol. 2013;27(3):167–175.

Shields J.A., Shields C.L. Rhabdomyosarcoma: review for the ophthalmologist. Surv Ophthal-mol. 2003;48:39–57


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