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    General

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    Grand Rounds

    A child presented to the Bascom Palmer Emergency Room complaining of 1 month of intermittent right eye swelling and double vision, worsening in the past two weeks. Visual acuity was 20/30 OD (ph), 20/20 OS. Intraocular pressures were within normal limits, and there was no afferent pupillary defect. Examination revealed limitations in supraduction and abduction of the right globe, and hypoglobus in primary gaze. MRI Brain and Orbit was performed and revealed an enhancing lesion of the right orbit. Orbitotomy was performed, with results consistent with embryonal rhabdomyosarcoma. The patient received a combination of proton beam radiation and systemic chemotherapy. Initially there was limited success with marked recurrence. The approach of chemotherapy was changed to intra-arterial chemotherapy with delivery to the right eye directly. After two sessions, the tumor was notably significantly reduced in size. This case highlights the multifaceted and complex approach to handling recurrent orbital rhabdomyosarcoma in a child.

    Presentation Date: 12/11/2025
    Issue Date: 01/09/2026

    • Presenter: Kisha Kalra, MD URL
    • Faculty Discussant: Sander R. Dubovy, MD URL
    • Faculty Discussant: David T. Tse, MD URL

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