Malignant Fibrous Histiocytoma (Kennerdell Case 36, PPT)

History: A 52-year-old man who was referred with an eight month history of decreasing vision in the right eye. Visual acuity in the right eye was 20/20- and the left eye 20/20. He had an enlarged blind spot on right visual field testing and a 3 mm right proptosis. Anatomy: Orbit. Clinical: Visual acuity in the right eye was 20/20- and the left eye 20/20. Disease Diagnosis: Histiocytoma, Malignant Fibrous. Pathology: The appearance of a malignant fibrous histiocytoma which was previously thought to be a hemangioma. A magnified view of the malignant fibrous histiocytoma cells. Another magnified view of the malignant fibrous histiocytoma cells. Presenting Symptom: Decreasing vision in the right eye; enlarged blind spot on right visual field testing and a 3 mm right proptosis. Neuroimaging: Ultrasound with beam coming from left to right shows the posterior wall of the eye and a cystic lesion in the retrobulbar space immediately behind the eye in a nasal position. Axial CT scan with the irregularly rounded tumor adjacent to the nasal posterior aspect of the right eye in the orbit Axial MRI showing the enhancing tumor that appears to be attached to the posterior nasal right globe. Treatment: Surgical removal of tumor.