V Limawararut1, E Hoyama, D Selva, G Davis. 1. Oculoplastic and Orbital Division, Department of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, Australia.
Abstract
PURPOSE: To report clinical and radiologic findings of cystic squamous cell carcinoma (SCC) of the orbit with evidence of perineural involvement. METHODS: Analysis of clinical findings and radiology with a literature review. RESULTS: A 66-year-old man with SCC of the forehead 8 years prior presented with paraesthesias, diplopia, and proptosis. Magnetic resonance imaging showed a well-defined, cystic mass of the orbit with a single, linear structure running through its center. Lateral orbitotomy revealed a cyst adherent to adjacent periorbita containing viscous, clear, yellow substance and a nerve coursing through the center. Histopathology confirmed poorly differentiated spindle cell carcinoma with positive staining for cytokeratin markers, consistent with SCC. CONCLUSIONS: Orbital cysts associated with altered sensation are suggestive of SCC with perineural spread, requiring prompt investigation and treatment to minimize morbidity and mortality. The involved nerve may be seen as a single, linear structure within the mass on imaging.
PURPOSE: To report clinical and radiologic findings of cystic squamous cell carcinoma (SCC) of the orbit with evidence of perineural involvement. METHODS: Analysis of clinical findings and radiology with a literature review. RESULTS: A 66-year-old man with SCC of the forehead 8 years prior presented with paraesthesias, diplopia, and proptosis. Magnetic resonance imaging showed a well-defined, cystic mass of the orbit with a single, linear structure running through its center. Lateral orbitotomy revealed a cyst adherent to adjacent periorbita containing viscous, clear, yellow substance and a nerve coursing through the center. Histopathology confirmed poorly differentiated spindle cell carcinoma with positive staining for cytokeratin markers, consistent with SCC. CONCLUSIONS: Orbital cysts associated with altered sensation are suggestive of SCC with perineural spread, requiring prompt investigation and treatment to minimize morbidity and mortality. The involved nerve may be seen as a single, linear structure within the mass on imaging.