Congenital orbital teratomas.

Teratomas of the orbit, rare congenital tumors consisting of normal tissues derived from all three germ cell layers, are probably choristomas rather than true neoplasms, and must be considered in the differential diagnosis of neonatal orbital masses. They typically grow rapidly after birth, causing destructive proptosis and exposure keratopathy; however, they may take a slowly progressive course, expanding slightly over several years. We studied two cases of histopathologically proven orbital teratomas. In one patient, a 2-month-old girl, the tumor was solid and enlarged rapidly after birth. In the other patient, a 15-year-old girl, the mass was cystic and grew at a very slow rate. In the latter case, vision was preserved, presumably because of the ease with which the tumor could be bluntly dissected from the ocular tissue. We believe that, when possible, early and complete extirpation is the procedure of choice, to ensure the greatest likelihood of visual preservation and symmetric orbital growth.