Malignant teratoma of the orbit: A clinicopathological study of a case

PURPOSE To present a case of malignant sarcomatous changes in an orbital teratoma with clinicopathological correlation. MATERIALS & METHODS Retrospective interventional case report. RESULTS A 10-month-old child presented with protrusion of the left eye of 8 months duration. Computerized tomography (CT) revealed a heterogeneous retrobulbar mass in the left orbit. Fine needle aspiration biopsy (FNAB) revealed sarcomatous cells. The child was treated with chemotherapy and radiotherapy with a provisional diagnosis of sarcoma. However, as the proptosis worsened, a repeat CT scan showed a possibility of an intracranial extension. Exenteration was done. Histopathological examination revealed a teratoma with (malignant) sarcomatous changes. The child is doing well at 3 years follow-up with no recurrences. CONCLUSION Orbital teratomas should be considered in the differential diagnosis of all neonatal orbital masses. Although rare, malignant changes can occur in teratomas. FNAB is not helpful in the diagnosis. Surgical excision of the mass is recommended for a definitive diagnosis. Although the prognosis of orbital teratoma is good, there is always a chance of vision loss.