PMC5944002_01
A: The clinical appearance of the massive right side proptosis with corneal exposure keratopathy. B: The trans illumination of the right huge orbital mass showing cystic areas. C: Axial magnetic resonance T-2 weighted image showing the mult-loculated mass with massive proptosis of the right globe. D: Sagittal T-1 weighted post-contrast image showing right orbital mass with focal hyper-intense area posteriorly.
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A full-term baby boy of 3.2 kg was born with right severe proptosis (Fig. 1A). On examination, there was a huge orbital lesion with trans illumination causing completely prolapsed right globe (Fig. 1B). No definite focal cerebral lesions were detected with normal appearing ventricular system (Fig. 1C and D).
A: Intra-operative appearance of the isolated capsulated right orbital mass for excision. B: The gross appearance of the mass excised. C: The appearance of the right salvaged globe several months after excision.
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The patient underwent left eye examination under anesthesia and debulking of the right orbital lesion with salvaging of the globe (Fig. 2A). The specimen consisted of a well demarcated multi-lobulated mass measuring mm x mm with apparent cystic areas (Fig. 2B). The patient was seen few months post-operatively with no evidence of recurrence (Fig. 2C).
Several elements of the teratoma in this case demonstrating adipose tissue, glandular structures, bone, cartilage, smooth muscle and respiratory epithelium in A through F (Original magnificationx 200 Hematoxylin and Eosin). G: The primitive neuroepithelium of the immature teratoma with adjacent cartilage (Original magnificationx 400 Hematoxylin and Eosin). H: The neuroepithelial component expressing synaptophysin with rosette-like configuration (Original magnificationx 200).
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The histopathological examination showed: a large encapsulated tumor mass consisting of different tissues from all 3 germline components, which included respiratory epithelium, secretory epithelium, bone, cartilage, skeletal muscle, and neural tissue (Fig. 3A-C).