ArticleInternational medical case reports journal2025
Ocular Hypertropia Mimicking Inferior Rectus Palsy as an Atypical Presentation of Parameningeal Rhabdomyosarcoma in a Child.
Article in International medical case reports journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Rhabdomyosarcoma (RMS) originates from undifferentiated mesenchymal cells that give rise to striated muscles. The symptoms of para-meningeal RMS often resemble those of allergic rhinosinusitis, including nasal congestion, mucus discharge, headache, and occasional nosebleeds. We report a child with atypical clinical presentation of ocular hypertropia secondary to para-meningeal RMS. Case Presentation: A child presented with an upward deviation of the left eye. He had a history of blunt trauma to the face before 5 days. Computed tomography (CT) of the head revealed a soft tissue density involving the left maxillary sinus. The magnetic resonance imaging (MRI) showed a 37.6 mm x 38.4 mm lesion within the left maxillary sinus extending to the orbit, nasal cavity, and premaxillary and retro maxillary areas with a heterogeneous signal and mild heterogeneous enhancements. A biopsy and histopathology confirmed alveolar RMS. The child was treated with chemotherapy and radiotherapy. Conclusion: Pediatric RMS with orbital extension mimicking benign conditions is challenging to diagnose and manage. Hypertropia following eye trauma can obscure severe underlying conditions, such as para-meningeal RMS. The inferior rectus lesion mimicking inferior rectus palsy stresses a thorough evaluation, including imaging and biopsy. Early and accurate diagnosis is crucial for the effective management of children with such aggressive malignancy.
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