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CASE REPORT |
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Year : 1991 | Volume
: 39
| Issue : 1 | Page : 33-34 |
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Orbital lymphangiomatoid malformation-A case report
Sandeep Saxena, RC Saxena, PK Agrawal
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
Source of Support: None, Conflict of Interest: None | Check |
PMID: 1894344
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 |
Introduction | | |
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 | | |
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 | | |
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 | | |
1. | Duke Elder S, Textbook of ophthalmology Vol.5, Henry Kimpton London. 5577, 1952. |
2. | Wecker L. Klin Monatsbi Augenheilkd. 6: 47-49, 1868. |
3. | Forster J, Munch. med. wschr. 33 : 617, 1886. |
4. | Weisner B.V.. Graefes Arch Ophthal. 32 : pg 2, 205, 1886. |
5. | Peyman G.A., Sanders D.R., Goldberg M.F., Principles and Practice of Ophthalmology Vol 3, Jaypee Brothers. New Delhi, 2159. 1987. |
6. | Ayres S.C.. Amer. J. Ophthal. 12 : 321. 1895. |
7. | Bullock L.J., Reeves R.J. Amer. J. Roentogenol Radium Ther Nucl Med. 82 : 290-299. 1959. |
8. | Henderson J.W.. Orbital Tumors. W.B. Saunders Company Philadelphia. 161, 1973. |
9. | Porterfield J.F.. Int Ophthal Clin. 2 : 319-335. 1962. |
10. | Mortada A, Brit. J. Ophthal, 46 : 45-50. 1962. |
11. | Watson W.L, Mc Carthy W.D, Surg. Gynaec. Obstet. 71 : 6569. 1940. |
12. | Werncke T, Mitt. Augenkl. Jurjew. 2 : 81, 1904. |
[Figure - 1], [Figure - 2], [Figure - 3]
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