|Year : 1971 | Volume
| Issue : 1 | Page : 31-33
Department of Pathology, S.C.B. Medical College, Cuttack, India
R C Misra
Department of Pathology, S.C.B. Medical College, Cuttack
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Misra R C. Orbital rhabdomyosarcoma. Indian J Ophthalmol 1971;19:31-3
Orbital tumours are relatively uncommon in ophthalmic practice and rhabdomyosarcomas are still rarer. The first rhabdomyosarcom was described in 1854 by Weber. Stout  published a detailed report on the subject in 1946. Regarding orbital rhabdomyosarcoma Calhown and Reese  published five cases in 1942. Frayer and Enterline  (1959) added twelve cases. Forterfield and Zimmerman  added fifty-five cases to the literature and summarized all the earlier reports. The addition of 62 cases of Jones, Reeseand & Kraut to the 110 previously reported cases brings the total number of reported orbital rhabdomyosarcoma to 172. It was felt necessary to report the present case in view of its rare occurrence.
Male, aged 62 years, attended ophthalmic outpatient department for the following complaints
1. Progressive unilateral proptosis 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 atrophy 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 contributory.
A clinical diagnosis of intraorbital 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 without any arrangement. The stroma was inconspicuous and at places vascular. Wide areas of necrosis and haemorrhage were observed.
A very small number of mesenchymal cells were seen. (Photomicrograph 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 nucleoli were seen in large numbers. In others the nuclei were hyperchromatic and long. Giant cells with multilobed and superimposed nuclei were conspicuous. Mitotic figures were frequent. (Photomicrograph 2.) Peripherally vacuolated spider cells with appearance of Rachet cells and tadpole cells were seen. From the above features a diagnosis of Rhabdomyosarcoma was made in the absence of demonstrable striations.
The case reported is of a Rhabdomyosarcoma 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. Microscopically 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 undifferentiated or embryonic tumours which constitute about 40 per cent of all the rhabdomyosarcomas.
| 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. Literature is reviewed briefly.
| References|| |
CALHOWN, F. P., Jr. & REESE A. B., Rhabdomyosarcoma of orbit, Arch. Ophthalm., (Chicago) 27 : 558, 1942.
FORTERFIELD J. F. & ZIIVIMERMAN L. E, Rhabdomyosarcoma of Or bit, A clinicopathological study of 55 cases, quoted by Jones et al. in 4.
FRAYER W. C. & ENTERLINE, H. T., Embryonal Rhabdomyosarcoma of the Orbit in Children & young adults, Arch. Opthalm. (Chicago) 62:203, 1959.
JONES I. S., REESE, A. B, and KRAUT J, Orbital Rhabdomyosarcoma -Analysis of 62 Cases, Am. J. Ophth., 61:721, 1966.
REESE, A. B., Tumours of the Eye, New York, Hoeber, 1963.
STOUT, (1946), quoted by Jones et al. 1966 in 4.
WEBER, (1954), quoted by Jones et al 1966 in 4.
[Figure - 1], [Figure - 2]