# Orbital Teratoma in an Adult: A Case Report and Literature Review

## TL;DR

A 24-year-old man with an adult-onset orbital teratoma had successful surgery and no recurrence, highlighting diagnostic and treatment challenges.

## Contribution

This case report adds to the limited literature on adult-onset orbital teratomas and emphasizes the effectiveness of frontotemporal craniotomy for resection.

## Key findings

- The tumor contained tissues from all three germ layers, confirming a mature teratoma.
- Complete resection via frontotemporal craniotomy resulted in no recurrence and improved ocular motility.
- Diagnostic challenges exist in distinguishing orbital teratomas from other fat-containing lesions in adults.

## Abstract

Orbital teratomas are rare congenital tumors that are typically diagnosed in infancy due to rapidly progressive proptosis. Adult-onset orbital teratomas are exceedingly rare, with only a few cases reported in the literature. We present the case of a 24-year-old man who developed progressive right-sided proptosis and diplopia. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a well-circumscribed mass in the superolateral right orbit containing areas of fat attenuation without calcification or bony erosion. The tumor was completely resected via a frontotemporal craniotomy. Histopathological examination revealed mature tissues derived from all three germ layers: ectodermal (nerve bundles), mesodermal (adipose tissue and vascular elements), and endodermal (salivary gland-like glandular tissue). These findings confirmed the diagnosis of a mature teratoma. At six-month follow-up, there was no radiologic or clinical evidence of recurrence, and ocular motility had markedly improved. This case illustrates the diagnostic challenges of distinguishing adult-onset orbital teratoma from other fat-containing orbital lesions, such as dermoid cysts or lipomas. It also demonstrates that, when the lesion extends into the superolateral orbit, a frontotemporal craniotomy provides safe and complete resection with favorable functional and cosmetic outcomes.