Inflammatory orbital pseudotumor with extension beyond the orbit.

Abstract

PURPOSE:

To summarize the clinical profile and response to treatment of 4 biopsy-proven cases of inflammatory orbital pseudotumor extending beyond the orbit.

DESIGN:

Retrospective observational case series.

METHODS:

Four patients' charts were retrospectively reviewed. There were three men with extraorbital extension (two intracranial; one maxillary antrum) and one woman with intracranial disease that extended into the orbit. The men were 40, 41, and 60 years old; the woman was 73 years old.

RESULTS:

Two men with orbital myositis and mild discomfort, initially treated with corticosteroids, had asymptomatic intracranial disease 9 and 12 months after initial presentation. A third man had extension into the maxillary antrum after initial symptoms of painless diplopia. The woman had intraorbital disease with minimal discomfort (dacryoadenitis and myositis) 5 years after presenting with intracranial disease in the Meckel cave that subsequently became bilateral. Histopathologic examination in all cases showed nonspecific inflammation without evidence of vasculitis or granulomas.

CONCLUSIONS:

Unlike typical cases of nonspecific orbital inflammation, two of these four cases did not have pain as a prominent feature. Neuroimaging was essential in diagnosing asymptomatic extraorbital disease. Surgery has a prominent role in confirming this diagnosis, primarily by helping to rule out other diseases, such as those with granulomatous inflammation or vasculitis. Additional therapy was usually not required postoperatively.

• Authors: Michael A Mahr, Diva R Salomao, James A Garrity
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 138 Issue 3 Pg. 396-400 (Sep 2004) ISSN: 0002-9394 [Print] United States
• PMID: 15364221 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Glucocorticoids
• Immunosuppressive Agents

Topics

• Adult
• Aged
• Brain Diseases (diagnosis, etiology, therapy)
• Female
• Glucocorticoids (therapeutic use)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Magnetic Resonance Imaging
• Male
• Maxillary Sinus (pathology)
• Middle Aged
• Ophthalmologic Surgical Procedures
• Orbital Diseases (diagnosis, etiology, therapy)
• Orbital Pseudotumor (complications, diagnosis, therapy)
• Paranasal Sinus Diseases (diagnosis, etiology, therapy)
• Retrospective Studies
• Tomography, X-Ray Computed