Inferior Rectus Anomalies-MRI

8 yr old child with inability to look down   referred for MRI with clinical suspicion of inferior rectus anomaly. MRI shows hypoplasia of right inferior rectus belly compared with other muscles , possible accessory extraocular muscle just above it, with absence of left inferior rectus. Case submitted by Dr MGK  Murthy.

Teaching points

• All extraocular  muscles have been described to be absent congenitally, with most common being inferior recti, superior recti, and superior oblique , in that order
• Presence of accessory extraocular muscles with hypoplasia /aplasia  has recently been described. Associated with craniofacial  dysostosis, Neurofibromatosis , though isolated cases are common
•  Symptoms could be Hypertropia on the affected side, with limited depression of more affected side 

Solitary Fibrous Tumour of the Orbit-CT

SFT might be included in the differential diagnosis of soft tissue masses in the orbit, if one sees a markedly enhancing mass showing the similar characteristics to those of the internal carotid artery on postcontrast CT or MR images.  Since the first report by Klemperer and Rabin1 in 1931 as a primary spindle-cell tumor of the pleura, solitary fibrous tumor (SFT) has been recognized as a distinctive, though rare, pathologic entity that most commonly arises from the pleura and peritoneum.

Retinoblastoma-CT

Note the soft tissue lesion with calcification in the left globe.

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