Orbit

Question 1

Rhabdomyosarcoma
Most common P’ paediatric orbital malignant tumor)
Onset ?
Gender ?
Origin ?
Histology?

Answer 1

Onset 5-7 years 
Gender male 1.6 : female 1
Origin pluripotent mesenchymal t/s
Histology 
1. Embryonal (common)
2. Alveolar (poor diff)
3. Pleomorphic (well diff)

Question 2

CF of rhabomyosarcoma

Answer 2

• rapid onset
  1. Proptosis (80-100%)
  2. Conjunctival & eyelid swelling
  3. Blepharoptosis
  4. Palpable mass
  5. Pain

Question 3

Investigation of rhabomyosarcoma

Answer 3

1. Biopsy
2. B scan - irregular but well defined edge, Low/medium reflectivity
3. Color Doppler - very high internal flow
4. CT/MRI - irregular but well defined, mass +/-, bony erosion

Question 4

To of rhabomyosarcoma

Answer 4

1. Surgery for well circumscribed
2. Sx with radio & chemo for extensive tumor
3. Exenteration

Question 5

Staging of rhabomyosarcoma

Answer 5

Group I. Localised d/s (completely respected)
Group II. Microscopic d/s (remaining a/f biopsy)
Group III. Gross d/s (remaining a/f biopsy)
Group IV. Distant metastasis

Question 6

D/Dx of conjunctival nodules

Answer 6

Nonpigmented lesion
Benign
1. Pyogenic granuloma
2. SC haemorrhage 
3. Conjunctival granuloma 
4. Parasitic 

Tumor

1. Harmatomas
2. Choristomas
3. Epithelial tumor
4. Lymphangiectasia
5. Lymphangiomas
6. Juvenile xanthogranuloma
7. Neurofibromas & neurilemommas
8. Rhabomyosarcoma

Question 7

D/Dx of pigmented nodule

Answer 7

1. Conjunctival naevus
2. Melanocytes naevus
3. Naevus of ota
4. Malignant melanoma