|
SYMPTOMS
|
Ocular pain, Diplopia, Decrease in vision
|
|
APD, Rapidly developing proptosis (most common sign), Globe displacement (down and out), Ptosis, EOM restriction, Eyelid swelling, Conjunctival chemosis, Choroidal folds, Tortuous retinal vessels, Optic nerve edema or pallor
|
|
WORK-UP
|
Pupils, EOMs, Cover test, Ptosis evaluation, Exophthalmometry, Full eye exam with dilation
|
|
TREATMENT
|
Refer to a Pediatric ophthalmologist or Ocular oncologist STAT for treatment which could include surgical removal, radiation, and/or chemotherapy
|
|
FOLLOW-UP
|
Once the rhabdomyosarcoma is treated by an ocular oncologist/pediatric ophthalmologist and the eye is stable, the patient should be seen back in 3-4 months for the first visit followed by every 4-6 months
|
|
ADDITIONAL LAB | TESTS
|
CT or MRI of the orbit (most likely will be ordered by the ocular oncologist or pediatric ophthalmologist)
|
|
ETIOLOGY
|
Malignant sarcoma that develops in the orbital soft tissue
|
|
DIFFERENTIAL DX
|
Neuroblastoma, Lymphangioma, Hemangioma, Orbital cellulitis
|
|
NOTES
|
An orbital rhabdomyosarcoma is the most common primary orbital malignancy in children
|
|
The majority of rhabdomyosarcomas involve the superior or superior nasal aspect of the orbit
|
|
If left to grow, an orbital rhabdomyosarcoma can cause a neoplastic meningitis
|
