Which orbital tumor is known to cause rapid bone destruction that progressively leads to unilateral proptosis?

• A. Neuroblastoma
• B. Lymphoma
• C. Rhabdomyosarcoma
• D. Optic nerve glioma

Answer: (C)

Rhabdomyosarcoma is an aggressive tumor of skeletal muscle lineage that tends to invade and destroy surrounding orbital bones quickly. This rapid bone destruction causes the eye to protrude forward in a unilateral, progressively enlarging proptosis, which is a hallmark presentation in children. Imaging often shows destructive changes of the orbital walls and possible sinus involvement. Other tumors can cause proptosis as well, but they typically grow more slowly and show less early bone erosion—optic nerve glioma enlarges along the nerve with slower progression, orbital lymphoma tends to be indolent, and neuroblastoma metastasis can cause proptosis but bone destruction is not the defining early feature.