Dutton Jonathan J, Wright John D
Department of Ophthalmology, University of North Carolina, Chapel Hill, NC, USA.
Orbit. 2006 Sep;25(3):227-33. doi: 10.1080/01676830600575519.
We describe a rare intramuscular infiltrating lipomatous tumor affecting the superior oblique muscle. A 37-year-old female presented with eyelid swelling, proptosis and motility disturbance. Imaging studies revealed enlargement of the superior oblique muscle with a fat-density infiltrating lesion within its belly. The clinical and radiologic findings suggested a cystic or necrotic lesion. Biopsy showed an infiltrative tumor consisting of adipocytes with included degenerated muscle fibers. Histologic features were consistent with a benign intramuscular lipoma, rather than the more aggressive well-differentiated liposarcoma. A review of the literature found three previously described periorbital cases, two in the eyelid, and one in the anterior orbit. Lipomas are common tumors that usually do not cause functional impairment but are very rare in the orbit. Intramuscular lipoma is a rare subtype that can result in significant morbidity. Enlargement of an extraocular or periorbital muscle with a low-density infiltrating lesion should raise suspicion for this unusual tumor.
我们描述了一例罕见的累及上斜肌的肌内浸润性脂肪瘤。一名37岁女性出现眼睑肿胀、眼球突出和眼球运动障碍。影像学检查显示上斜肌增粗，肌腹内有脂肪密度的浸润性病变。临床和影像学表现提示为囊性或坏死性病变。活检显示为浸润性肿瘤，由包含退变肌纤维的脂肪细胞组成。组织学特征符合良性肌内脂肪瘤，而非更具侵袭性的高分化脂肪肉瘤。文献回顾发现了3例先前报道的眶周病例，2例位于眼睑，1例位于眶前部。脂肪瘤是常见肿瘤，通常不会导致功能损害，但在眼眶中非常罕见。肌内脂肪瘤是一种罕见的亚型，可导致明显的发病率。眼外肌或眶周肌增粗并伴有低密度浸润性病变时，应怀疑这种不寻常的肿瘤。
