Primary synovial sarcoma of the orbit in a paediatric patien
The following case has been reported in the journal
Therapeutic Advances in Ophthalmology.

A 6-year-old girl presented with 1-week history of gradual painless proptosis of the right eye. Ophthalmologic examination revealed 20/20 visual acuity in both eyes, no conjunctival congestion, no afferent pupillary defect, and a normal fundus. The ocular protrusion was measured by Hertel exophthalmometry.

Results showed 18 mm for the right eye, 13 mm for the left eye, and the interorbital distance was 90 mm. A well-defined, nonmobile, nontender soft mass 4 cm × 3 cm in size was palpated in the temporal portion of the right orbit. The mobility of the right eye was limited in upgaze and lateral gaze.

An orbital CT scan revealed a uniform density soft-tissue mass in the right lateral orbital wall area extending into the orbit, the intracranial, the temporal fossa, and the adjacent soft tissues. There was no clear boundary between the mass and lateral rectus, and the neighboring orbital wall was destroyed. Contrast-enhanced CT combined with CT angiography showed a nonuniform enhancement soft mass 4 cm × 5.5 cm × 6.5 cm in size invading the right sphenoid and temporal bone.

The mass displaced the right middle cerebral artery a little bit, and the boundary with the branch of right anterior cerebral artery was not very clear. MRI of the orbit showed a mass with mixed long T1 and long T2 signals in the right retrobulbar region outside the muscle cone. The right lateral orbital wall was destroyed, the lateral rectus was compressed, and the right temporal lobe was pushed backward with a clear boundary noted. No abnormalities were detected on systemic examinations, including blood and urine tests, abdominal ultrasound, and chest CT.

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