A forty years old female patient from Somalia presented with a large 15 cms mass protruding from the left side of her face obstructing her vision. The tumour had been gradually growing in size for the past six months and now covered almost the entire left side of her face. A careful examination revealed it to be a pedunculated mass arising from the left orbit which was confirmed by a CT-scan. The eyeball and soft tissues of the orbit were infiltrated by the mass but there was no evident bony destruction of the orbital walls.
A biopsy from the lesion indicated a poorly differentiated carcinoma and IHC studies ruled out lymphoma/sarcoma. A whole-body PET scan ruled out metastasis elsewhere in the body and the patient underwent surgery. An orbital exenteration (removal of the eyeball, attached muscles and soft tissues of the orbit) was performed along with total excision of the tumour. The upper eyelid had to be excised, but the lower eyelid was preserved. A temporalis muscle flap was transposed to fill the cavity and the orbit was closed by mobilizing the lower eyelid skin. The patient recovered well and is due to undergo postoperative radiotherapy.
Dr Umanath Nayak, M.S., Fellow UC Davis, California, (Senior Consultant Head & Neck Surgeon)
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