PMC6090953_01
Case report timeline
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Fig1
An 80-year-old Arabian female presented to our hospital with a 2-month history of swelling over the right eyebrow, pain, proptosis of the right eye and diplopia (Fig. 1).
Histological aspect of the lesion in biopsy: a The tumour is composed of interlacing bundles of spindle cells (H&E x 100). b The neoplastic cells show anisokaryosis and hyperchromatic nuclei (H&E x 400)
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Fig2
On microscopic examination, the tumour was composed of interlacing bundles of spindle cells with anisokaryosis and hyperchromatic nuclei (Fig. 2).
Gross features of the exenterated orbital contents: Cut surface shows ill-defined, whitish and firm tumour. It is attached to the sclera without infiltration into eyeball. It infiltrates the upper eyelid. The tumour is extending to the surgical margins
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Fig3
It infiltrated the upper eyelid (Fig. 3).
Histological aspect of the tumour after orbital exenteration: a Neoplastic spindle cells are arranged in disorganized fascicules (H&E x 100). b The tumour is attached to the sclera without infiltration (H&E x 40). c Infiltration into adipose tissue and striated muscle is observed (H&E x 40). d High-power view shows the obvious cytologic atypia and several mitoses of the neoplastic cells (H&E x 400)
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Fig4
Adipose tissue and striated muscle infiltration was observed (Fig. 4).
Immunohistochemical profile of the tumour after orbital exenteration: The tumor cells express pancytokeratin AE1/AE3 a, EMA b, SMA (c) and express focally S100 protein (d)
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Fig5
It revealed diffuse positive staining for pancytokeratin AE1/AE3, EMA and SMA and focal positivity for S100 protein (Fig. 5).
Immunohistochemical profile of the tumour after orbital exenteration: The tumor cells are negative for desmin (a) (infiltrated skeletal muscle fibers are staining with desmin) and CD34 (b) (vessel endothelial cells are staining with CD34)
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Fig6
The lesion was immunonegative for desmin and CD34 (Fig. 6).