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   Table of Contents      
CASE REPORT
Year : 1991  |  Volume : 39  |  Issue : 1  |  Page : 33-34

Orbital lymphangiomatoid malformation-A case report


Department of Pathology & Bacteriology, King George's Medical College, Lucknow, India

Correspondence Address:
Sandeep Saxena
Department of Pathology & Bacteriology, King George's Medical College, Lucknow
India
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Source of Support: None, Conflict of Interest: None


PMID: 1894344

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  Abstract 

An asymptomatic orbital lymphangiomatoid malformation in a female is being reported.


How to cite this article:
Saxena S, Saxena R C, Agrawal P K. Orbital lymphangiomatoid malformation-A case report. Indian J Ophthalmol 1991;39:33-4

How to cite this URL:
Saxena S, Saxena R C, Agrawal P K. Orbital lymphangiomatoid malformation-A case report. Indian J Ophthalmol [serial online] 1991 [cited 2019 Jun 27];39:33-4. Available from: http://www.ijo.in/text.asp?1991/39/1/33/24484


  Introduction Top


Lymphangioma is a rare, congenital orbital tumour, in association with perivascular lymphatics [1]. It was first reported by Wecker [2] in 1868 but detailed original obser­vations were made by F φrster [3]sub and Weisner [4]. It usually becomes clinically apparent in the early years of childhood and tends to involve the' superior orbit [5]. It usually grows so slowly that advice is not sought until the patient has reached adult life [6]. In the present case an asymptomatic lymphangiomatoid malformation un­derneath the superomedial margin of the orbit, lying anterior to the orbital septum, was observed. The rarity of this malformation and its unusual clinical presentation prompted this case report.


  Case report Top


M.D., a 30 year old female, was admitted in our depart­ment with a painless, progressive swelling underneath the superomedial orbital margin of 4 years duration. On examination her visual acuity in both eyes was 6/6. A non- tender swelling was present underneath the medial one third of the left superomedial orbital margin [Figure - 1].

It was round, well defined, firm in consistency and the overlying skin was freely mobile and not discoloured. There was no associated proptosis or strabismus. The anterior and posterior segments . of both eyes were normal. There was no associated swelling elsewhere in the body. X ray orbit did not show any bony deformity.

Under local anaesthesia, this mass was excised for cosmetic reasons. It was situated anterior to the orbital septum and was not attached to the bone or the perios­teum. It was firm, pinkish white, oval and measured 1 1 x 8 x 6 mm [Figure - 2].

Histopathological examination showed dilated lym­phatic spaces separated by dense intervening connec­tive tissue stroma with lymphocytes consistent with the diagnosis of Ivmphangiomatoid malformation [Figure - 3].


  Discussion Top


Lymphangiomatoid malformation of the orbit or the ocular adenexa is not common. The incidence of this tumour as reported in various series of orbital tumours is 0.8% [7]sub , 0.6% [8]sub , and at the most 2.3% [9]. The literature mentions most of such neoplasms in the orbit, although the orbit is free of lymphatic vessels [10]. It is believed that orbital lymphangiomata originate either from displaced foetal cells of lymphatic channels [11] or from lymphan­giomata extending from the 'id and conjunctiva [12].

In the present case a clinical diagnosis of lymphan­giomatoid malformation was not considered because firstly, it was not present since early childhood (accord­ing to the patient) and secondly, it was neither soft nor it had fluctuation. Its diagnosis was made only after histopathological studies. Presence of excessive and dense intervening connective tissue explained its firm consistency and absence of fluctuation. Its situation anterior to the orbital septum explained the absence of proptosis and strabismus.

 
  References Top

1.
Duke Elder S, Textbook of ophthalmology Vol.5, Henry Kimpton London. 5577, 1952.  Back to cited text no. 1
    
2.
Wecker L. Klin Monatsbi Augenheilkd. 6: 47-49, 1868.  Back to cited text no. 2
    
3.
Forster J, Munch. med. wschr. 33 : 617, 1886.  Back to cited text no. 3
    
4.
Weisner B.V.. Graefes Arch Ophthal. 32 : pg 2, 205, 1886.  Back to cited text no. 4
    
5.
Peyman G.A., Sanders D.R., Goldberg M.F., Principles and Practice of Ophthalmology Vol 3, Jaypee Brothers. New Delhi, 2159. 1987.  Back to cited text no. 5
    
6.
Ayres S.C.. Amer. J. Ophthal. 12 : 321. 1895.  Back to cited text no. 6
    
7.
Bullock L.J., Reeves R.J. Amer. J. Roentogenol Radium Ther Nucl Med. 82 : 290-299. 1959.  Back to cited text no. 7
    
8.
Henderson J.W.. Orbital Tumors. W.B. Saunders Company Philadelphia. 161, 1973.  Back to cited text no. 8
    
9.
Porterfield J.F.. Int Ophthal Clin. 2 : 319-335. 1962.  Back to cited text no. 9
    
10.
Mortada A, Brit. J. Ophthal, 46 : 45-50. 1962.  Back to cited text no. 10
    
11.
Watson W.L, Mc Carthy W.D, Surg. Gynaec. Obstet. 71 : 6569. 1940.   Back to cited text no. 11
    
12.
Werncke T, Mitt. Augenkl. Jurjew. 2 : 81, 1904.  Back to cited text no. 12
    


    Figures

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



 

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