|Year : 1967 | Volume
| Issue : 2 | Page : 75-76
Myxoma of the orbit
DL Maria, V Marwa
Depts. of Ophthalmology and Surgery, Medical College, Aurangabad, India
|Date of Web Publication||18-Jan-2008|
D L Maria
Depts. of Ophthalmology and Surgery, Medical College, Aurangabad
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Maria D L, Marwa V. Myxoma of the orbit. Indian J Ophthalmol 1967;15:75-6
Myxoma is an extremely rare orbital tumour, characterized by its mucin content, which stains red with mucicarmine. The tumour arises from rests of muciform embryonic tissue which is the parent substance of several varieties of the mesodermal group especially fat, cartilage, bone and connective tissue. There is often an associated lipoma. Sites of appearance are the skin, the periosteum, as well as any area where there is loose connective tissue and fat, such as the orbit. Five cases of myxoma of the orbit have been reported so far. (Maucione, Fuchs, Lamb, Bistis, Giffords). The average age of the patient was 27 years, the oldest patient being 40 years old and the youngest 16 years. The lesions were diffuse and poorly demarcated with a tendency to infiltrate all the orbital structures. The tumour grows slowly and produces a high degree of exophthalmos.
| Case Report|| |
A male muslim patient aged 50 years was admitted to the ophthalmic ward on 11-6-1965 with the complaints of gradual protrusion of the left eyeball since three years. There was no diminution of vision since the onset of this complaint. No history of sinusitis. Family history was not contributory. General physical examination did not reveal anything of importance (Plate 1)-[Figure - 1].
| Local Examination|| |
Right eye was normal except for diminished acuity of vision. 6/ 18 without glasses. Left eye-ball was proptosed, slightly pushed upward, lowerhalf of sclera being more exposed. The palpebral fissure was widened and bulbar conjunctiva in the exposed part was dirty grey in colour and xerosed. The movements showed slight limitation to the outer and down and out sides. The fundus showed slight blurring of upper nasal border of the disc. Vision of the left eye was 6/ 18.
Digital examination showed a cystic growth behind the eyeball which could be felt from the lateral and lower side of the orbit. It was diagnosed provisionally as haemangioma of the orbit, because of its extremely slow growth, its cystic feel, position of the eyeball and maintenance of his primary vision.
X-Ray of the orbit in A.P. view showed enlarged size. There was haziness of uniform density. The lateral orbital wall was broken through. The orbital fissures were normal. Paranasal sinuses were normal. X-Ray Chest, total and differential leucocytic counts, V.D. R.L., and stool examination were within normal limits. His E.S.R. was 25 mm Hg 1st hour and Hb 11 Gm.
Patient was given antianaemic treatment and a course of streptopenicillin for seven days because of his high E.S.R.
Kronleins lateral orbitotomy was done on 22-6-1965 with the help of Dr. V. Marwa, Professor of Surgery under general anaesthesia. It was seen that the lateral orbital wall was eroded and periosteum of the aterial wall was deficient through which the growth was bulging. The growth was well defined, greyish, friable with a sticky feel, of the size of wallnut. It was extending right to the superior orbital fissure. The external rectus muscle was pulled up with the strabismus hook and the growth was completely shelled out with the finger. Macroscopically the growth was identified as myxoma and a portion was sent for histopathological examination, which confirmed it as myxoma with no anaplastic changes.
The patient was put on tetracycline, calcium with vitamin C, and B 1 and B 12 250 mg injections. There was reactionary oedema of lids and chemosis for about six days.
On 30th June patient started complaining of diplopia in the upward and outward direction and there was limitation of eye movements in these directions. There was slight ptosis also. A course of Kenacort (Triaminolone) was given for ten days along with nervine tonics. Patient was discharged on 8-8-1965 with slight restrictions of movements of eyeball in the upward and lateral directions with slight ptosis, fundus was normal. Vision of both eyes was 6/18 as it was at the time of admission. (Plate 3)-[Figure - 3]
| Summary|| |
An extremely rare case of orbital myxoma was seen in a male muslim patient aged 50 years. Clinical diagnosis was made as haemangioma of the orbit. Kronlein's lateral orbitotomy was done and a tumour of the size of walnut was shelled out which was identified macroscopically as myxoma, confirmed by histopathological examination.
| Acknowledgement|| |
Our thanks are due to Dr. K. D. Sharma, Professor of Pathology for the histopathological report.
| References|| |
Blegvad, O. (1944), Actaophath (Kbb) 22: 131-140.
Bistis. G. (1931). Arch. d'ophth 48: 440-442.
Fuchs, E. (1944). Ztschr Augenh 32. 192.
Gitford. S. R. (1931), Arch. Ophth. 5: 445-448.
Lamb. H. D. (1928), Arch. Ophth. 57: 425-429.
Maucione. L. (1913). Arch. Ottal. 21: 300-306.
Reese. A. B. (1963). Tumours of the eye. P. 455-456, Harper and Row, New York.
[Figure - 1], [Figure - 2], [Figure - 3]