A Case Report: Congenital Mature Orbital Teratoma

1. Shereen Aiyub¹
2. John Szetu¹
3. Lawrence Sullivan²
4. Dinesh Selva³

¹Pacific Eye Institute, Suva, Fiji
²Bayside Eye Specialist, Melbourne, Australia.
³Royal Woman and Children Hospital, Adelaide, Australia.

Purpose
We report a first case of primary congenital mature orbital Teratoma ever reported and documented in the Western Pacific region and discuss how this case was managed.

Method
Teratoma means monstrous growth in Greek. Proptosis at birth is rare and may be due to variety of tumors and structural abnormalities. Congenital Orbital Teratoma is a rare cause of unilateral exophthalmos in newborns. In 1862, Holmes reported the first case of Teratoma. The English literature has reported 70 cases since then. According to the Department of Pathology, CWM Hospital, Suva, Fiji, this is the first reported case of Congenital Orbital Teratoma in the country. Case report of a female infant born with gross non-pulsatile right orbital proptosis.

Results
CT scan – multicystic mass is seen in the right orbit with evidence of calcification. No intracranial extension is evident. B scan – Multicystic mass and solid areas. Cytology Report – Cystic content with occasional epitheloid cells showing nuclear features which are suspicious of malignancy. Histology Report: Fibro adipose tissue, one fragment shows well defined colonic type mucosa with goblet cells and payers patch-like sub mucosal lymphocyte aggregates. There is no immature component seen.

Conclusion – In our case the Teratoma had the derivatives of all three germ cell layer and there was no sign of malignancy or intracranial extension. The cystic component was decompressed and lesion was excised en bloc.