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ARTICLE
Year : 1967  |  Volume : 15  |  Issue : 2  |  Page : 75-76

Myxoma of the orbit


Depts. of Ophthalmology and Surgery, Medical College, Aurangabad, India

Date of Web Publication18-Jan-2008

Correspondence Address:
D L Maria
Depts. of Ophthalmology and Surgery, Medical College, Aurangabad
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Maria D L, Marwa V. Myxoma of the orbit. Indian J Ophthalmol 1967;15:75-6

How to cite this URL:
Maria D L, Marwa V. Myxoma of the orbit. Indian J Ophthalmol [serial online] 1967 [cited 2024 Mar 28];15:75-6. Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?1967/15/2/75/38687

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 Top


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 Top


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 Top


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 Top


Our thanks are due to Dr. K. D. Sharma, Professor of Pathology for the histopathological report.[7]

 
  References Top

1.
Blegvad, O. (1944), Actaophath (Kbb) 22: 131-140.  Back to cited text no. 1
    
2.
Bistis. G. (1931). Arch. d'ophth 48: 440-442.  Back to cited text no. 2
    
3.
Fuchs, E. (1944). Ztschr Augenh 32. 192.  Back to cited text no. 3
    
4.
Gitford. S. R. (1931), Arch. Ophth. 5: 445-448.  Back to cited text no. 4
    
5.
Lamb. H. D. (1928), Arch. Ophth. 57: 425-429.  Back to cited text no. 5
    
6.
Maucione. L. (1913). Arch. Ottal. 21: 300-306.  Back to cited text no. 6
    
7.
Reese. A. B. (1963). Tumours of the eye. P. 455-456, Harper and Row, New York.  Back to cited text no. 7
    


    Figures

  [Figure - 1], [Figure - 2], [Figure - 3]



 

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Case Report
Local Examination
Summary
Acknowledgement
References
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