Two rare cases of orbital mass following scleral buckling procedure

Purpose: There have been several reports of patients undergoing scleral buckling (SB), presenting as an orbital mass. Here we present two rare cases. Methods: Case one is a 49 year old female patient with a history of SB 1.5 years earlier that presented with 5mm proptosis of the right eye since three months ago. Case 2 is a 63 year old female patient that presented with a hyperpigmented orbital mass with a history SB procedure. Results: For case 1, Orbital Magnetic resonance imaging (MRI) revealed a heterogenous mass with hyperintese and hypointense signal on T1, hypointense on T2 and enhancement with gadolinium. Patient underwent exploration. In histopathology and immunohistochemistry report, atypical tumoral cells that were positive for (HMB)-45 and S100 protein, negative for PAN-CK and EMA were seen compatible with malignant melanoma. For case 2 On orbital MRI a well-defined crescent mass was seen, that had hypoitense signal in T1, hyperintense in T2. Clinically a differential diagnosis of a hemorrhagic cyst due to SB was made. The mass regressed after removing the scleral buckle. Conclusion: Any patient with a history of SB and presentation of orbital mass should be considered for orbital imaging, exploration and if needed biopsy for a possible malignancy.