PMC4707774_01
Preoperative photograph shows a palpable mass on left superonasal orbit (a, arrow). Axial (b) and coronal (c) planes of computed tomographic scan show a circumscribed soft tissue mass on the left superonasal orbit with heterogenic density containing areas of fat attenuation. The mass demonstrates heterogenous enhancement (d)
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Fig1
External examination revealed 3 mm of relative proptosis of the left eye and a nontender palpable firm mass in the left superonasal orbit (Fig. 1a). Computed tomographic scan demonstrated a circumscribed, heterogeneous orbital mass displacing the left globe laterally (Fig. 1b, c and d).
Grossly, the tumor is a 1.8 x 1.8 x 1.3 cm yellowish, encapsulated, solid mass (a). Microscopic features of the tumor shows it is comprised of spindle to ovoid-shaped muscle cells interspersed with irregular vascular channels and mature adipocytes (b, hematoxylin and eosin stain, original magnification, x100). Immunohistochemical staining reveals that the proliferating vessels are positive for CD34 (c) and smooth muscle cells are positive for HHF-35 (d) (original magnification, x100)
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Fig2
At the time of surgery, the 1.8 x 1.8 x 1.3 cm yellowish mass was encapsulated and solid (Fig. 2a). Histologically, the orbital mass was composed of mature adipocytes, intermingled with spindle or oval-shaped cells with eosinophilic cytoplasm, accompanied by thick-walled blood vessels (Fig. 2b). Immunohistochemically, tumor cells were positive for CD34 and HHF-35 (Fig. 2c and d), but negative for cytokeratin, HMB-45 and Melan-A.