Orbital Dirofilariasis Masquerading As Orbital Rhabdomyosarcoma
Purpose: To report a 12-year-old patient with a rapid growing orbital mass and imaging findings suggestive of rhabdomyosarcoma that was found to be dirofilariasis after mass resection.
Case Report: We describe a 12-year-old patient with a rapid growing orbital mass involving medial part of orbit and medial rectus muscle and imaging findings suggestive of rhabdomyosarcoma. Histopathologic examination showed the mass to be composed of granulomatous inflammation and the thread-like object to be Dirofilaria repens. The patient was well post-operation without morbidity. In this paper, we describe distinct clinical features and imaging findings of this interesting case.
Conclusion: Deep orbital lesions due to dirofilariasis, as in our case, is extremely rare. It is important to add dirofilariasis to the differential diagnosis of orbital mass lesions. Attention to the imaging clues, as provided in this report, can be helpful.
Dirofilariasis, Parasitic Infection, Orbital Mass, Orbital Tumor, Zoonotic Infection
1. Padhi TR, Das S, Sharma S, Rath S, Rath S, Tripathy D, et al. Ocular parasitoses: A comprehensive review. Surv Ophthalmol 2017;62:161–189.
2. Maraghi S, Rahdar M, Akbari H, Radmanesh M, Saberi AA. Human dirofilariasis due to Dirofilaria repens in Ahvaz - Iran: A report of three cases. Pak J Med Sci 2006;22:211– 213.
3. Rouhani S, Athari A. Ocular dirofilariasis in Iran: A case report. Med J Islam Republ Iran 2003;17:85–86.
4. Jamshidi A, Jamshidi M, Mobedi I, Khosroara M. Periocular dirofilariasis in a young woman: A case report. Korean J Parasitol 2008;46:265–267.
5. Tavakolizadeh S, Mobedi I. Orbital dirofilariasis in Iran: A case report. Korean J Parasitol 2009;47:397–399.
6. Simón F, Siles-Lucas M, Morchón R, González-Miguel J, Mellado I, Carretón E, et al. Human and animal dirofilariasis: The emergence of a zoonotic mosaic. Clin Microbiol Rev 2012;25:507–544.
7. Kalogeropoulos CD, Stefaniotou MI, Gorgoli KE, Papadopoulou CV, Pappa CN, Paschidis CA. Ocular dirofilariasis: A case series of 8 patients. Middle East Afr J Ophthalmol 2014;21:312–316.
8. Gorezis S, Psilla M, Asproudis I, Peschos D, Papadopoulou C, Stefaniotou M. Intravitreal dirofilariasis: A rare ocular infection. Orbit 2006;25:57–59.
9. Groell R, Ranner G, Uggowitzer MM, Braun H. Orbital dirofilariasis: MR findings. AJNR Am J Neuroradiol 1999;20:285–286.
10. Davis R, Barsoumian A, Mauffray R, Caldwell M, Drayna P, Crosson J. Dirofilaria presenting as orbital mass. Orbit 2015;34:38–40.
11. Henderson BM, Hunt CH, Eckel LJ, Schwartz KM, Diehn FE, Pritt BS, et al. Intramuscular dirofilariasis mimicking an orbital metastasis in a patient with breast cancer. Case Rep Radiol 2012;2012:103154.
12. Bhat S, Saldanha M, Mendonca N. Periocular dirofilariasis: A case series. Orbit 2016;35:100–102.