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 Table of Contents    
CLINICAL QUIZ
Year : 2012  |  Volume : 5  |  Issue : 2  |  Page : 135  

Bilateral, symmetrical zygomatic mass


1 Department of Ophthalmology, College of Medicine and Health Sciences, Sultan Qaboos University Hospital, Muscat, Oman
2 Department of Pathology, College of Medicine and Health Sciences, Sultan Qaboos University Hospital, Muscat, Oman

Date of Web Publication4-Aug-2012

Correspondence Address:
Abdullah Al-Mujaini
Department of Ophthalmology, Sultan Qaboos University Hospital, PO- 38, PC-123, Muscat
Oman
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-620X.99385

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How to cite this article:
Al-Mujaini A, Wali UK, Joda DA, Qureshi A. Bilateral, symmetrical zygomatic mass. Oman J Ophthalmol 2012;5:135

How to cite this URL:
Al-Mujaini A, Wali UK, Joda DA, Qureshi A. Bilateral, symmetrical zygomatic mass. Oman J Ophthalmol [serial online] 2012 [cited 2020 Jun 3];5:135. Available from: http://www.ojoonline.org/text.asp?2012/5/2/135/99385

A 39-year-old female presented with bilateral symmetrical subcutaneous swelling over both cheeks (zygomatic areas) since 18 months. The swelling is painless and has been almost stable for the past six months. There is no h/o double vision. On palpation the swellings are firm and mobile. Slit-lamp examination revealed normal anterior and posterior segment examinations. Visual acuity is 20/20 in each eye and extraocular movements are normal. MRI shows a homogeneous dense mass on both sides [Figure 1]. Macroscopy showed nodular gray and yellow tissue with solid yellow surface.
Figure 1: MRI orbits. Arrows show the bilateral zygomatic mass

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Histological sections revealed spindle cells with plump nuclei and thick collagenization of stroma. Inset shows CD 68. Immunohistochemical stain showed diffuse positivity [Figure 2]a. There are sheets of foamy macrophages. No nuclear atypia is seen [Figure 2]b.
Figure 2: Immunohistopathology

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   Question: Top


Which one of the listed below is most likely the diagnosis?

  1. Dermoid cysts
  2. Neurofibroma
  3. Fibrous histiocytoma
  4. Fibrohistiocytic neoplasms
  5. Wegener's granuloma
  6. Lymphoma


The followings points can be used as clues to establish the diagnosis.

  1. The disease tends to be more common in males than in females.
  2. It is common in head and neck region.
  3. Usually asymptomatic.
  4. Classified as a mesenchymal tumor of soft tissue.
  5. Characterized by spindle-shaped cells in storiform pattern.




Click here to view answer. View Answer



    Figures

  [Figure 1], [Figure 2]



 

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