PMC7374210_01
(a) Transabdominal ultrasound of the mother at 36 weeks of pregnancy showing a right orbital mass. (b) Congenital exophthalmia (5 cm). (c) CT scan of the head and the orbits: heterogeneous mass in the left orbit with cystic, calcified, fatty, and vascularized tissues. (d) 3D skull scan: enlarged left orbital cavity. (e) Left eye: corneal abscess with perforation.
CRIOPM2020-1597353.001.jpg
PMC7374210_01_CRIOPM2020-1597353.001.jpg
fig1
Ophthalmic exam was normal for the right eye while showing on the left eye (Figure 1(b)) a multilobulated hypervascularized, nonpulsatile, nonreducible massive proptosis. Computerized tomography scan of the head and orbits revealed a heterogeneous mass with cystic, calcified, fatty, and vascularized tissues (Figure 1(c)). The orbital cavity was enlarged with no bone lyses (Figure 1(d)).
(a) Tumor removed. (b) Empty orbital cavity after mass exeresis. (c) Gross appearance of the mass : a multilocular cyst.
CRIOPM2020-1597353.002.jpg
PMC7374210_01_CRIOPM2020-1597353.002.jpg
fig2
Surgical treatment consisted in removing the entire mass (Figure 2(a)) while sparing the eyelids. The orbital cavity remained empty (Figure 2(b)). Gross appearance of the mass (Figure 2(c)) revealed a multilocular cyst with clear substance and areas without endocystic vegetations.
(a) Histological examination showing respiratory tissue. (b) Histological examination showing a cluster of neuroganglion cells and nerve cells. (c) Histological examination showing cartilage tissue (top left) and bone tissue (bottom). (d) Histological examination showing a cartilaginous lobule in the middle of an adipose lobule. (e) Histological examination showing keratinized malpighian epithelium.
CRIOPM2020-1597353.003.jpg
PMC7374210_01_CRIOPM2020-1597353.003.jpg
fig3
Microscopic exam showed that the cyst was boarded by a layer of mature tissues such as respiratory (Figure 3(a)) or intestinal (Figure 3(b)) type linings, keratinized malpighian epithelium (Figure 3(c)), cartilaginous nodules (Figure 3(d)), clusters of lymphoid cells, and nervous tissues (Figure 3(e)).
Left orbital cavity to be repaired.
CRIOPM2020-1597353.004.jpg
PMC7374210_01_CRIOPM2020-1597353.004.jpg
fig4
Postsurgery outcomes were without any complications (Figure 4).