Primary Germinoma of the Orbit

Abstract

We report an extremely rare case of a primary orbital germinoma in a previously healthy 56-year-old man. The patient had a 3-month history of progressive left proptosis and visual deterioration. A magnetic resonance imaging scan revealed an intraconal enhancing mass superomedially displacing the optic nerve and abutting the ocular globe. The patient underwent a lateral orbitotomy with en bloc tumor resection. Histologically, the tumor was found to be a germinoma. The patient's postoperative course was uneventful, and no adjuvant therapy was performed. Periodic imaging study results of the testes, mediastinum, and the whole body were negative for tumors. At the last follow-up, 24 months after surgery, proptosis had resolved, visual acuity in the left eye had improved, and magnetic resonance images confirmed complete tumor removal. To our knowledge, this is the first report of a primary germinoma of the orbit. Although highly unusual, orbital germinomas widen the spectrum of described orbital germ cell tumors and should be considered in the differential diagnosis of primary intraorbital tumors.