A rare case of pediatric teen orbital alveolar subtype rhabdomyosarcoma in Saudi Arabia Eastern Province: A case report

Introduction: To report a rare presentation of an alveolar orbital rhabdomyosarcoma and the corresponding findings on computed tomography (CT), magnetic resonance imaging (MRI), and surgical outcome. Case Report: A 14-year-old Saudi boy, who presented with a progressively enlarging left upper eyelid mass. Associated with proptosis and limitation of extra-ocular muscles. He underwent imaging including CT scan and MRI which both modalities showed a large left intraconal mass with extraconal extension. The patient underwent a subtotal excision of the mass. Biopsy was sent for histopathology revealed a diagnosis of alveolar rhabdomyosarcoma, solid variant. Histogenetics, including fluorescence in situ hybridization (FISH) analysis for the FOXO1 gene, showed a negative gene rearrangement. The patient was referred to the oncology center in Dammam for confirmation of the diagnosis and to initiate appropriate management based on the disease stage. Conclusion: This case report highlights a rare instance of orbital alveolar rhabdomyosarcoma (RMS) in a 14-year-old boy from the Eastern Province of Saudi Arabia. Despite being a highly malignant tumor with aggressive progression typically affecting younger children, our patient presented with a relatively slower progression and a 6-week history of enlarging swelling and non-axial proptosis.