Indian Journal of Ophthalmology

ARTICLES
Year
: 1971  |  Volume : 19  |  Issue : 1  |  Page : 31--33

Orbital rhabdomyosarcoma


RC Misra 
 Department of Pathology, S.C.B. Medical College, Cuttack, India

Correspondence Address:
R C Misra
Department of Pathology, S.C.B. Medical College, Cuttack
India




How to cite this article:
Misra R C. Orbital rhabdomyosarcoma.Indian J Ophthalmol 1971;19:31-33


How to cite this URL:
Misra R C. Orbital rhabdomyosarcoma. Indian J Ophthalmol [serial online] 1971 [cited 2024 Mar 29 ];19:31-33
Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?1971/19/1/31/34999


Full Text

Orbital tumours are relatively uncommon in ophthalmic practice and rhabdomyosarcomas are still rarer. The first rhabdomyosarcom was described in 1854 by Weber[7]. Stout [6] published a detailed report on the subject in 1946. Regarding orbital rhabdomyosarcoma Calhown and Reese [1] published five cases in 1942. Frayer and Enter�line [3] (1959) added twelve cases. Forterfield and Zimmerman [2] ad�ded fifty-five cases to the litera�ture and summarized all the ear�lier reports. The addition of 62 cases of Jones, Reeseand & Kraut[4] to the 110 previously reported cases brings the total number of reported orbital rhabdomyosar�coma to 172. It was felt necessary to report the present case in view of its rare occurrence.

History

Male, aged 62 years, attended ophthalmic outpatient depart�ment for the following complaints

1. Progressive unilateral prop�tosis of left eye of two months duration.

2. There was mild downward and medial displacement of the globe.

3. Slight impairment of lateral rotation of eye-ball.

4. Diplopia of fifteen days' duration.

5. Visual acuity was slightly impaired.

6. Papilloedema and optic atro�phy were not found.

7. An ill-defined soft mass could be palpated in the lateral aspect of the orbit underneath the skin. The skin was not adherent to the mass.

8. Regional lymphnodes not enlarged.

X-ray of the orbit was nil con�tributory.

A clinical diagnosis of intra�orbital tumour was made and a small mass of tissue was removed and sent for biopsy to ascertain the nature of the growth. It was not possible to follow up the case as the patient did not turn up after biopsy.

Grossly the tissue measured about 3 cm x 2 cm, greyish-brown in colour and soft in consistency. Cut surface showed minute areas of haemorrhages.

Microscopically the section showed the presence of tumour cells scattered irregularly with�out any arrangement. The stroma was inconspicuous and at places vascular. Wide areas of necrosis and haemorrhage were observed.

A very small number of mesen�chymal cells were seen. (Photo�micrograph 1). The tumour cells were of extremely variable size and shape with eosinophilic granular cytoplasm. Cytoplasmic outlines were irregular. Striation could not be demonstrated in PTAH strain. Vesicular nuclei of bizarrae appearance having peripherally arranged chromatin and prominent eosinophilic nu�cleoli were seen in large numbers. In others the nuclei were hyper�chromatic and long. Giant cells with multilobed and superimposed nuclei were conspicuous. Mitotic figures were frequent. (Photo�micrograph 2.) Peripherally vacuolated spider cells with ap�pearance of Rachet cells and tad�pole cells were seen. From the above features a diagnosis of Rhabdomyosarcoma was made in the absence of demonstrable striations.

Comment

The case reported is of a Rhab�domyosarcoma in an old man of sixty-two years. The growth was perhaps small in size and about few months in duration. Clinically it was diagnosed as a malignant tumour of the orbit. Microscopi�cally the tumour presented all features of rhabdomyosarcoma except demonstrable striations. As striation is a further step towards differentiation it is not expected to be present in more undifferen�tiated or embryonic tumours which constitute about 40 per cent of all the rhabdomyosarco�mas.

 Summary



A case of rhabdomyosarcoma of orbit in a man of sixty-two years is reported in view of its rarity. Histological appearance of the tumour is described. Litera�ture is reviewed briefly.

References

1CALHOWN, F. P., Jr. & REESE A. B., Rhabdomyosarcoma of orbit, Arch. Ophthalm., (Chicago) 27 : 558, 1942.
2FORTERFIELD J. F. & ZIIVIMER�MAN L. E, Rhabdomyosarcoma of Or bit, A clinicopathological study of 55 cases, quoted by Jones et al. in 4.
3FRAYER W. C. & ENTERLINE, H. T., Embryonal Rhabdomyosarcoma of the Orbit in Children & young adults, Arch. Opthalm. (Chicago) 62:203, 1959.
4JONES I. S., REESE, A. B, and KRAUT J, Orbital Rhabdomyosarcoma -Analysis of 62 Cases, Am. J. Ophth., 61:721, 1966.
5REESE, A. B., Tumours of the Eye, New York, Hoeber, 1963.
6STOUT, (1946), quoted by Jones et al. 1966 in 4.
7WEBER, (1954), quoted by Jones et al 1966 in 4.