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Arch Ophthalmol. 1998;116:1528-1530.

Background  There are several rare tumors that can cause proptosis in an infant, including infantile myofibroma.

Methods  A 3-month-old infant developed a painless, bone-destructive superomedial orbital mass, raising concern for orbital malignant neoplasms. Computed tomography disclosed a bone-destructive mass of the sphenoid wing. On magnetic resonance imaging, the intraosseous mass was well-circumscribed, surrounded by cortical bone, and showed prominent enhancement.

Results  Superomedial orbitotomy and biopsy revealed a lesion composed of spindled to stellate cells, without mitotic activity, set in a fibromyxoid stroma. Immunohistochemical stains were positive for vimentin and actin. Ultrastructurally, there were actinlike thin filaments, mitochondria, and rough endoplasmic reticulum, confirming a myofibroblastic proliferation and supporting the diagnosis of congenital infantile myofibroma.

Conclusion  Infantile myofibroma is a benign tumor that occurs rarely in the ocular region but can cause prominent bone destruction, misleading the clinician to suspect a malignant neoplasm.

Carol L. Shields, MD; Michael Husson, MD; Jerry A. Shields, MD; Gary Mercado, MD; Ralph C. Eagle, Jr, MD
From the Oncology Service (Drs C. L. Shields, J. A. Shields, and Mercado) and the Pathology Department (Dr Eagle), Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pa; and the Pathology Department, Pennsylvania Hospital, Phildelphia (Dr Husson).