Purpose: To bring in perspective a rare case of spindle-cell sarcoma of lid with intra-orbital metastasis.
Methods: A seventy-five year old female presented with complaints of severe pain in right eye and right sided headache for 2 months along-with constant watering. She had a history of cataract surgery with IOL implantation in bag in right eye 4 months back. During the same time, a mass lesion was also removed from underside of right lower lid which was present for about 7-8 years. She was asthenic in built and was found to have pallor. On ophthalmic examination she was found to have Snellen’s visual acuity of 6/60 OD, 6/18 OS. Intra-ocular pressure was 37.5 mm of Hg OD, 18.6 mm of Hg OS. Ocular movements were restricted in lateral and superior gaze in right eye. On palpation stony hard, tender induration could be appreciated along the right infero-nasal lid margin. Fundus examination revealed chorio-retinal folds in inferior quadrant peripherally. No palpable lymph nodes were observed. CT scan brain and orbit was advised along-with routine blood investigations and IOP control medications.
Results: CT scan revealed a heterogeneous cystic lesion measuring 17 × 16 × 21 mm in antero-inferior right orbit, abutting the globe and inferior rectus with thickening of uveo-scleral ring. The right globe was compressed and displaced supero-laterally. No bony erosion or infiltration of orbital fat or optic nerve was seen. Earlier histo-pathological report of excised lid tumor revealed low grade spindle cell sarcoma.
Conclusion: Spindle cell sarcoma of lid is rare entity. This case report reveals a spindle cell sarcoma of lid with intraorbital metastasis.
Abhishek Onkar, Suwarna Suman and Saurabh Samdariya