In a recent article describing a useful well-known technique for reconstruction after orbital exenteration, Uusitalo and coworkers1 described a patient who underwent orbital exenteration for primary rhabdomyosarcoma. We find this surprising because the Intergroup Rhabdomyosarcoma Study found a 10-year overall survival rate of 87% with use of chemotherapy with or without adjunctive radiation.2 Our service (Oculoplastic and Orbital Surgery, Massachusetts Eye and Ear Infirmary, Boston, Mass) refers biopsy-proved cases of orbital rhabdomyosarcoma to pediatric oncology, where the present protocol includes 1 year of intravenous vincristine sulfate and dactinomycin with or without radiation. It would be interesting to know what specific characteristics of this case indicated exenteration.
Fay A, Fynn-Thompson N, Varvares M. Reconstruction After Orbital Exenteration. Arch Ophthalmol. 2003;121(11):1662. doi:10.1001/archopht.121.11.1662-a