An unusual presentation of orbital rhabdomyosarcoma: A case report

Orbital rhabdomyosarcoma (RMS) is the commonest orbital cancer in children. Capillary hemangioma (CH) is the commonest benign periorbital tumor in childhood. We present an unusual case of orbital RMS, which was initially diagnosed as an orbital CH. An 8-year-old girl presented with a right eye protrusion of 3 years’ duration. The protrusion increased with the Valsalva maneuver. There was no history of headache, remarkable weight loss, or swelling of any other parts of the body. A diagnosis of orbital hemangioma was made, and she was commenced on propranolol with some improvement, but she defaulted. When she was represented 4 years later, there was a huge mass surrounding the right eye, with blindness and intermittent bleeding. Orbital computed tomographic angiography revealed features of a very vascular mass with bony expansion of all the orbital walls. She underwent modified exenteration, and her histology revealed Alveolar RMS. These reports highlight an unusual presentation of orbital RMS.