Three cases of orbital rhabomyosarcorria are reported here. Histological studies confirmed the lesion to be the alveolar type in all cases. This tumor a rare disease entity in Orient. Than Europe and America and accordingly, rarely encountered in our ophthalmologic practice, although-it is the commonest primary malignant orbital tumor in children. Of the three cases reported here one occurred in adult and the other two in children.
Case I. This 15 month old male showed a swelling of the left upper lid toward the medial side for 2 months and visited to our hospital on March, 10, ‘69 with complaints of progressive swelling on the region with ptosis. The eye. ball was slightly displaced toward the lower temporal side and ocular movement is limited to upward. On palpation, the child thumb sized tumor was palpable in the upper nasal portion of the orbit.
On excision of the tumor, the mass was found to be originated from the superior oblique muscle. The mass round measuring 2. 5 X 2. 5 X 1.5 cm in size. Histological diagnosis was alveolar rhabdomyosarcoma without cross-striation. No follow-up could be done.
Case II . This patient of 15 month-old male showed a swelling on the right lower lid existed 6 months and visited to our hospital on September 8, ´69. The physical examination revealed that the left eye sand the other routine examinations were within normal limits. The right eye showed the swelling of the lower lid, congestion of the palpebral conjunctiva, limited movement of the eye ball toward the lower side and a palpable bean-sized mass on the region.
The excision of tumor was performed under the general anesthesia. This mass was attached with the inferior oblique muscle with no other recognizable adhesion seemingly originating from that muscle. The mass was round and oval in shape, measuring 2 X 2 X 1cm in size, diagnosis was alveolar rhabdomyosarcoma. The post-operative follow-up studies were unavailable.
Case Ⅳ. This case in one of adult alveolar rhabdomyosarcoma. At the age of 25 years, this man showed a proptosis of the right eye associated with migrain like headache, ocular pain and visual disturbance. This symptoms existed 6 months and gradually increased in intensity. On the physical examination, the left eye was found to be normal. The skull and orbit x-ray and c.b.c, were with in normal limits. The right eye revealed about 5mm proptosis compared with left eye and the adult thumb sized tumor was palpated on the inner side of the lower orbital rim. The visual acuity was in zero. The right optic disc was edematous and elevated about 4.0 D. The pupil showed marked dilatation and the light reflex was absent and ocular movement was markedly limited and eye ball is deviated toward the upper side.
Under the general anesthesia, the exenterating of the orbit associated with the removal of tumor was carried out with no untoward complications. Origin of the mass was the inferior oblique muscle penetrating to the deeper part of the optic foramen and optic nerve was surrounded by the tumor completely. Histology confirmed alveolar rhabdomyosarcoma. Follow-up study was impossible.
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