Orbital malignant non-chromaffin paraganglioma. Alveolar soft tissue sarcoma.

MALIGNANT non-chromaffin paraganglioma, or what has beept designated "alveolar soft tissue sarcoma", was described as a distinct entity by Christopterson, Foote, and Stewart (1952). Most of the reported cases are from such sites as the thighs and the retroperitoneum (Stein, 1956; Pack and Ariel, 1958; Karnauchow and Magner, 1963; Vakil and Sirsat, 1963; Bhargava, Bhargava, Jeevandra Kumar, and Srikantiah, 1965; Indira, Gangadharam, Ramachandra Rao, and Reddy, 1965). Orbital cases are very few (Hogan and Zimmerman, 1962). A girl aged 13 years was seen at the Medical College Hospital, Kottayam, with swelling over the sclera, proptosis and impairment of vision in the left eye of 3 months' duration. Examination.-Her general health was normal. The left eye was proptosed, and medial and lateral movements were limited (Fig. 1). There was a painless, pinkish, vascular, fleshy growth on the lateral side of the orbit involving the lateral third of the lower fornix, the lateral canthus, and the lateral half of the upper fomix. Anteriorly it extended about 4 mm. from the lateral limbus. The swelling was covered by the conjunctiva and appeared to be circumscribed. The visual acuity was 6/60 and the fundus showed slight papilloedema with venous engorgement.