Abstract
BACKGROUND: Orbital tumors present at birth are rare and pose significant diagnostic and management challenges, especially when they exhibit late and aggressive features such as fungation and keratinization. Early identification and intervention are crucial in preventing functional and cosmetic complications. CASE PRESENTATION: We report the case of a 9-month-old female infant who presented with a protruding left eye since birth. On physical examination, a large fungating mass with a keratinized surface occupying the left orbital region was noted. Detailed imaging and histopathological evaluation were performed to determine the nature of the mass. Management strategies and outcomes are discussed. CONCLUSION: This case highlights the importance of early recognition and multidisciplinary management of congenital orbital masses. Our findings contribute to the limited literature on congenital orbital neoplasms presenting with fungating features, underscoring the necessity for timely diagnosis and intervention.