Rhabdomyosarcoma of the Lower Eye Fornix and Conjunctiva in a Child

A 6-year-old boy was presented with a small polypoid growth in inner conjunctival fornix of the left eye. The parents noted first the lesion as conjunctival congestion associated with dilated episcleral vessels three weeks ago. He received a trial of topical corticosteroid which was not helpful. Examination of the eye described a papillomatous fleshy tissue arising from the caruncle, extending onto bulbar conjunctivae, occupying about three clock hours (figure 1). A conjunctival punch biopsy was approached under general anesthesia which was compatible with embryonal rhabdomyosarcoma (RMS). Immunohistochemical analysis was positive for desmin and myoglobin. Orbital MRI scan showed an enhanced thickening of the lower part of the conjunctiva without orbital infiltration. Extensive staging work-up was negative. According to Intergroup RMS study classification, he was considered as stage III and was treated with chemotherapy alone. One month after chemotherapy eye examination was almost normal (figure 2). The child is in complete remission after 4 years.