Clinicopathological study of three cases of infantile fibromatosis of the orbit

Massive congenital cervicofacial desmoid-type fibromatosis in a 5-month-old infant

Desmoid-type fibromatosis (DF) is a borderline tumor of soft tissues that has low malignant potential but described as infiltrative, locally aggressive and rapidly growing. In the pediatric population, it occurs in the head and neck. Presentation varies based on tumor size and location. Despite the high recurrence rate, surgical excision remains the modality of choice with. Here, we report a case of a 5-month-old boy, with extensive head and neck DF that was managed twice with conservative debulking surgery through a combined transoral-transcervical approach. On 2-year follow-up, he was gaining weight with no developmental delay and had no clinical evidence tumor regrowth.

Solitary adult orbital myofibroma: Report of a case and review of the literature

Purpose

Myofibromas are benign soft tissue tumors commonly encountered in infancy and childhood. Developing usually within the first two years of life, they can be multicentric and involve deep visceral organs.

Observations

We present the rare occurrence of a solitary orbital myofibroma in an adult patient. The clinical, histopathologic and immunohistochemical findings of the tumor are documented.

Conclusions

A comprehensive review of pediatric and adult orbital and periocular involvement by myofibroma is presented. Its characteristic pathologic and molecular findings are reviewed.

Importance

Myofibromas are uncommon but important tumors that can occur in the head and neck region, including the orbit. Seen more often in children, they can rarely be encountered in adult patients. Diagnosis is possible with a panel of immunostains and molecular analysis can be further confirmatory.

Idiopathic Enlargement of the Extraocular Muscles in Young Patients: A Case Series

PURPOSE

To describe a case series of enlarged extraocular muscles in young patients.

DESIGN

Retrospective interventional case series.

METHODS

Study involves 6 young patients who presented with atypical restrictive strabismus and reduced eye movements. Examination, neuroimaging, biochemistry results, and biopsy results are presented. The surgeries are described, and the follow-up over 1-20 years is presented.

RESULTS

All 6 patients had enlarged extraocular muscles that caused restrictive strabismus. The patients had no significant medical history. There was no identifiable underlying pathology on biochemistry tests or muscle biopsy. Three of the patients required multiple surgeries.

CONCLUSION

Atypical presentations of strabismus should be investigated for systemic conditions. Neuroimaging of the orbit and brain and a biopsy of the affected muscles should be considered. The patients should be counseled that multiple surgeries may be necessary to improve the strabismus, and it is unlikely that orthotropia will be attained.