Orbital teratoma in the foetus: a rare case without proptosis
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CASE REPORT
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Orbital teratoma in the foetus: a rare case without proptosis Xi Chen1, Jiaxiang Yang1, Guannan He1, Chunlan Cheng2, Chunguo Zhang1, Hongli Wang1, Lihong He1, Zhirong Yang3, Li Chen4 and Jing Zhao1*
Abstract Background: Congenital orbital teratoma is relatively rare, and few reports of prenatal ultrasound findings in such cases have been published. Case presentation: A rare case of congenital orbital teratoma at 24 + 2 weeks of gestation was previously diagnosed as microphthalmia, noting how orbital teratoma without proptosis is different from microphthalmia, retinoblastoma and intracranial teratoma. Ultrasound examination, analysis of gross specimens, and histopathological evaluation confirmed the diagnosis of orbital teratoma. Conclusion: Prenatal ultrasound examination is useful for diagnosis and differential diagnosis of congenital orbital teratoma. Keywords: Orbital teratoma, Ultrasound, Proptosis, Foetal
Background Congenital orbital teratoma is relatively rare. These lesions are classified as mature or immature teratomas based on their degree of cellular differentiation. Orbital teratomas have been detected at birth or, more commonly, early in life due to clinical proptosis [1]. Nevertheless, foetal information is limited. Here, we report a prenatal case of mature orbital teratoma without proptosis at 24 + 2 weeks of gestation, with an initial diagnosis of microphthalmia. We present the ultrasound characteristics, gross specimens, and histopathological appearance. Case presentation A 25-year-old pregnant woman, gravida 1, para 0, at 24 + 2 weeks of gestation was referred to our department for prenatal ultrasound examination. Prenatal ultrasound examination revealed that the foetus’ eyes were asymmetrical. The right and left eye globes measured 10.9 × * Correspondence: [email protected] 1 Department of Ultrasound, Sichuan Provincial Hospital for Women and Children, No.290 Sha Yan Xi Er Street, Chengdu City, Sichuan Province, China Full list of author information is available at the end of the article
8.3 mm and 6.8 × 6.0 mm, respectively. The mean normal foetal orbital diameter is 11.0 mm at 24 weeks of gestation [2]. An initial diagnosis of microphthalmia was made. A hyperechoic lesion was detected in the left retro-orbital space. The lesion was crescent shaped, with a maximum thickness of about 1.6 mm (Fig. 1b); it was confined to the orbit and showed no proptosis. No shadowing calcifications were detected. Colour Doppler ultrasound examination demonstrated significant angiogenesis in the lesion (Fig. 1a). Prenatal ultrasound examinations showed no structural abnormalities other than asymmetry of the eyes, and the intracranial structure did not appear to be deformed. The head circumference, abdominal circumference and femur length were consistent with the gestational age. After consultation, the patient and her husband indicated that they wanted to induce labour. Autopsy demonstrated a normal facial appearance (image could be available upon reasonable request from the correspondi
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