Mature teratoma presenting as orbital cellulitis in a 5-month-old baby

Abstract

We have presented an interesting case of an unexpected orbital tumor in a 5-month-old female healthy baby who presented initially with a 1-week history of acute left proptosis, swollen eyelid, conjunctival chemosis and exposure keratopathy. She was treated with intravenous antibiotics without any improvement and was referred for the drainage of the left orbital abscess. The procedure was performed with partial resolution, however the proptosis persisted and an underlying orbital pathologic lesion was suspected. Further exploring the left orbital revealed a partially cystic tumor. The histopathologic features were consistent with a mature teratoma. The case is presented with a brief discussion on this entity to attract the attention of general ophthalmologists to such tumors in the orbit.

Congenital orbital teratoma: A case report

“…[4] However, the diagnosis may be delayed sometimes due to clinical features mimicking orbital cellulitis, causing significant visual morbidity. [2] Radiological features of benign orbital teratomas include multi loculated cystic mass with focal calcifications and fat. Eyeball is compressed and optic nerve may be displaced.…”

“…[1] Teratoma occurring at the head and neck region are uncommon. [2]Usually the orbital teratoma are localized and benign; however, very few have malignant potential. [3][4][5] The tumor grows rapidly, causing destructive proptosis and exposure keratopathy within days.…”

The Superinfection of Dermoid Cysts in Nigeria

“…Therefore, it occupies an interesting place in pathology. For instance, a recent report concerned its presentation as orbital cellulitis in a 5month-old baby [2]. However, it is in the ovary that it most frequently surfaces [3].…”

Ocular Adnexal Infections

“…For example, the literature reminds us that refractory cases may in fact be cause to consider alternate etiologies such as malignancy and inflammatory conditions. Examples of preseptal and orbital cellulitis mimicry reported over the past year include anaplastic large-cell lymphoma, CD56-negative extranodal NK/T cell lymphoma, choroidal melanoma, acute myelogenous leukemia, and mature teratoma [30][31][32][33][34]. We have found that having a low threshold for reconsidering diagnosis and a multi-disciplinary approach are helpful in refractory or aggressive cases to uncover possible masquerading conditions.…”