CASE PRESENTATION Fetal MRI obtained after abnormal prenatal ultrasonography demonstrated a multiloculated retro-orbital cystic mass with anterior displacement of the left globe (Panel A). Marked proptosis was present at birth (Panel B). Despite 3 intraorbital bleomycin injections, follow-up MRI showed no meaningful reduction in tumor size or mass effect (Panel C). The patient developed severe exposure keratopathy with corneal opacification prior to definitive surgical intervention, resulting in deep amblyopia. The lesion was excised via a lateral orbitotomy using a swinging lower eyelid incision with lateral canthotomy and inferior cantholysis. Drilling of the deep lateral orbital wall and entry into the medial orbital floor facilitated piecemeal tumor removal. Histopathologic examination confirmed a mature orbital teratoma. Postoperatively, the globe was structurally preserved with a satisfactory cosmetic outcome (Panel D), and the last documented visual assessment was fix and follow, maintained.
Arazi et al. (Thu,) studied this question.
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