Abstract
BackgroundGranular cell tumors are rare neoplasms which can occur in any part of the body. Granular cell tumors of the orbit account for only 3 % of all granular cell tumor cases. Computed tomography and magnetic resonance imaging of the orbit have proven useful for diagnosing orbital tumors. However, the rarity of intraorbital granular cell tumors poses a significant diagnostic challenge for both clinicians and radiologists.Case presentationWe report a case of a 37-year-old Chinese woman with a rare intraocular granular cell tumor of her right eye presenting with diplopia, proptosis, and restriction of ocular movement. Preoperative orbital computed tomography and magnetic resonance imaging with contrast enhancement revealed an enhancing solid, ovoid, well-demarcated, retrobulbar nodule. In addition, magnetic resonance imaging features included an intraorbital tumor which was isointense relative to gray matter on T1-weighted imaging and hypointense on T2-weighted imaging. No diffusion restriction of water was noted on either axial diffusion-weighted images or apparent diffusion coefficient maps. Both computed tomography and magnetic resonance imaging features suggested an intraorbital hemangioma. However, postoperative pathology (together with immunohistochemistry) identified an intraorbital granular cell tumor.ConclusionsWhen intraorbital T2 hypointensity and free diffusion of water are observed on magnetic resonance imaging, a granular cell tumor should be included in the differential diagnosis of an intraocular tumor.
Highlights
Granular cell tumors are rare neoplasms which can occur in any part of the body
When intraorbital T2 hypointensity and free diffusion of water are observed on magnetic resonance imaging, a granular cell tumor should be included in the differential diagnosis of an intraocular tumor
We report a case with a rare intraorbital granular cell tumor (GCT) presenting with diplopia, blurred vision, and exophthalmos, originally identified as an intraorbital hemangioma based on its imaging features
Summary
Our patient presented with diplopia and was found to have a solitary, well-defined intraorbital mass adjacent to or within her extraocular muscles. There was no diffusion restriction on DWI or ADC. When presented with these imaging features, GCTs should be included in the differential diagnosis of an intraorbital mass, involving the inferior rectus muscle. Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Authors’ contributions WHY and TCL designed the study. FPC and DMTH performed the histological examination. JFL and WYG performed the radiological examination. WHY, TCL, JFL, FPC, and DMTH analyzed and interpreted the patient data. WHY and TCL were major contributors to writing the manuscript. All authors read and approved the final manuscript
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