SHM Converge Scientific Abstract ePoster Gallery-Here's Pancreas in Your Eye! A Case of Recurrent Unilateral Periorbital Swelling in a Pediatric Patient

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A 3-year-old girl recently emigrated from El Salvador presented with two years of recurrent, unilateral left periorbital swelling associated with subjective fevers and pain. She had previously been treated with antibiotics with only partial improvement. On exam, she had mildly tender, non-erythematous swelling of the left upper and lower eyelids without conjunctival injection, proptosis, or extraocular movement abnormalities. Laboratory testing showed leukocytosis (WBC 15.4 x 10^9/L), while CRP, ESR, and the remainder of her labs were normal.<br /><br />MRI revealed a rim-enhancing cystic lesion in the left infratemporal fossa abutting the orbital apex. The ENT team performed biopsy and surgical resection of the mass. Cultures for AFB, fungal, aerobic, and anaerobic organisms were negative. Pathology demonstrated an adult mature teratoma containing minor salivary glands, sinonasal mucosa, and pancreatic tissue, confirmed by INSM-1 staining. Immunostains (GFAP, S100, neurofilament) showed no CNS tissue.<br /><br />The patient recovered well and was discharged on postoperative day 1.<br /><br />This case highlights that teratomas, though most commonly found in sacrococcygeal, gonadal, or mediastinal locations, can rarely occur in the head and neck. Mature head and neck teratomas are uncommon but should be considered in children with recurrent periorbital swelling that does not respond to standard treatment.

Asset Subtitle

Ashley B. Parker

Meta Tag

Author List Adam J. Kimple, Ashley B. Parker, Frederic Askin, John R. Stephens, Keonho A. Kong, Mark Chaskes

Category Clinical Vignettes

Concept Orbital Swelling

Concept Teratoma

Concept Mature Teratoma

Concept Immature Teratoma

Concept Mass

Distinguished Non-Finalist

Presenter Organization University of North Carolina- Chapel Hill School of Medicine

Presenting Author Ashley B. Parker

Track Pediatric

Keywords

teratoma

head and neck mass

periorbital swelling

orbital apex

infratemporal fossa

mature teratoma

pediatric case

MRI rim-enhancing lesion

salivary glands

pancreatic tissue

Orbital Swelling

Teratoma

Mature Teratoma

Immature Teratoma

Mass