Case Study: Atypical Presentation of Orbital Hemangiopericytoma

Abstract

Hemangiopericytoma is a slow growing, vascular mesenchymal tumor, which may behave like a malignant tumor, leading to local recurrence, or metastasis, or both. This report is about a 32-year-old lady with non-axial proptosis and diminished vision due to a mass lesion in the superomedial quadrant of the right orbit. CT scan and MRI reports showed no intracranial extension. Surgical intervention was done through the roof of the orbit keeping hemangioma, neuroma or schwannoma as the leading differential diagnoses; however, on aspiration, it was not bleeding. It was confirmed to be a hemangiopericytoma on histopathological examination. The unique presentation, where, on tapping, no blood was found, makes this case an example of diagnostic dilemma. This lack of bleeding might be due to vascular insufficiency of the mass. Proptosis disappeared the following day after the surgery and vision also showed significant improvement to 20/20 within a week after surgery. The patient has been kept on regular follow up keeping in mind the recurrent and metastatic behavior of the tumor.