Akshay G Nair1,2,3, Swaranjali S Gore1, Amol Y Ganvir1, Namrata G Adulkar4, Indumati Gopinathan5, Anuradha K Murthy6, Nayana A Potdar1, Chhaya A Shinde1. 1. Department of Ophthalmology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India. 2. Ophthalmic Plastic Surgery and Ocular Oncology Services, Advanced Eye Hospital and Institute, Navi Mumbai, India. 3. Aditya Jyot Eye Hospital, Mumbai, India. 4. Consultant Orbit and Oculoplastic Surgeon, Mumbai, India. 5. Clinico Path Labs, Mumbai, India. 6. Metropolis Healthcare Ltd., Mumbai, India.
Abstract
AIM: To describe and review the clinical, radiological, and histopathological characteristics of an orbital perivascular epithelioid cell tumor (PEComa). METHODS: A systematic review of clinical records, radiological investigations, microscopic features, and immunohistochemical characteristics was done. RESULTS: A 9-year-old female child presented with a year-long history of a large orbital mass associated with painless, progressive proptosis of the right eye. Radiologically, a well-defined orbital mass was seen with no intracranial extension. Excision was performed and histopathological examination showed uniform epithelioid cells in nests separated by thin fibrovascular septae. The tumor cells stained positively for Human Melanoma Black-45, but neg-atively for desmin, S-100, smooth muscle actin, MyoD1, microphthalmia-associated transcription factor, vimentin, CD10, CD31, and CD34 with a low proliferation index of 5-7%. Based on the tumor's morphological and immuno-histochemical characteristics, a diagnosis of giant orbital PEComa was made. No recurrence was seen at the last follow-up. CONCLUSIONS: PEComas are uncommon mesenchymal neoplasms that have typical histological features, with an immunohistochemical profile of negativity for epithelial markers and positivity for melanocytic markers. For benign PEComas, complete excision is advised. However, since PEComas elsewhere in the body have been known to be malignant, a close follow-up of such cases is recommended.
AIM: To describe and review the clinical, radiological, and histopathological characteristics of an orbital perivascular epithelioid cell tumor (PEComa). METHODS: A systematic review of clinical records, radiological investigations, microscopic features, and immunohistochemical characteristics was done. RESULTS: A 9-year-old female child presented with a year-long history of a large orbital mass associated with painless, progressive proptosis of the right eye. Radiologically, a well-defined orbital mass was seen with no intracranial extension. Excision was performed and histopathological examination showed uniform epithelioid cells in nests separated by thin fibrovascular septae. The tumor cells stained positively for Human Melanoma Black-45, but neg-atively for desmin, S-100, smooth muscle actin, MyoD1, microphthalmia-associated transcription factor, vimentin, CD10, CD31, and CD34 with a low proliferation index of 5-7%. Based on the tumor's morphological and immuno-histochemical characteristics, a diagnosis of giant orbital PEComa was made. No recurrence was seen at the last follow-up. CONCLUSIONS: PEComas are uncommon mesenchymal neoplasms that have typical histological features, with an immunohistochemical profile of negativity for epithelial markers and positivity for melanocytic markers. For benign PEComas, complete excision is advised. However, since PEComas elsewhere in the body have been known to be malignant, a close follow-up of such cases is recommended.
Authors: Andrew L Folpe; Thomas Mentzel; Hans-Anton Lehr; Cyril Fisher; Bonnie L Balzer; Sharon W Weiss Journal: Am J Surg Pathol Date: 2005-12 Impact factor: 6.394
Authors: Emiko Furusato; J Douglas Cameron; Roger W Newsom; Takashi Fujishiro; Takayoshi Kojima; Charles S Specht; John F Fetsch; Bungo Furusato; Isabell A Sesterhenn; Elisabeth J Rushing Journal: Hum Pathol Date: 2010-03-17 Impact factor: 3.466