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Myositic type of idiopathic orbital pseudotumor in a 4-year-old child: a case report.

Bakan S, Bakan AA, Cingu AK, Beker Acay M, Gocmez A, Elbeyli A, Sencer S - Case Rep Med (2012)

Bottom Line: It is the third most common orbital disease after thyroid orbitopathy and lymphoproliferative disorder.This paper describes a 4-year-old girl who presented with sudden ptosis in the right eye and swollen eyelid.She recovered completely with high-dose steroid therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Viransehir State Hospital, 63100 Sanliurfa, Turkey.

ABSTRACT
Idiopathic orbital pseudotumor is a benign, noninfectious, and nonneoplastic disease with unknown cause. It is the third most common orbital disease after thyroid orbitopathy and lymphoproliferative disorder. Idiopathic orbital pseudotumor is extremely rare in pediatric age group and may cause real diagnostic problems. This paper describes a 4-year-old girl who presented with sudden ptosis in the right eye and swollen eyelid. She recovered completely with high-dose steroid therapy. We report clinical and magnetic resonance imaging findings of orbital myositis, which is a rare subtype of idiopathic orbital pseudotumor in children and needs to be differentiated from other orbital disease especially malignancy.

No MeSH data available.


Related in: MedlinePlus

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Mentions: A previously healthy and normally developing 4-year-old girl presented to our pediatric clinic with a 2-day history of painless, gradually progressing ptosis and swollen right eyelid. Visual acuity was 20/20 in her both eyes. Ophthalmological examination of the patient was normal other than upper eyelid ptosis, proptosis, and ophthalmoplegia in the right eye. She was not able to use her left leg and left arm at admission. For this reason, cranial computed tomography (CT) was performed to check for intracranial hemorrhage or mass and turned out to be normal. Complete blood count, electrolyte levels, and sedimentation rate were in normal ranges. There was no atypical cell in peripheral blood smear. In orbital MRI examination, postgadolinium fat-saturated T1-weighted images revealed marked contrast enhancement of medial (Figure 1(a)) and inferior rectus (Figure 1(b)) muscles. MRI also showed enlargement of superior, inferior, and medial rectus muscles and their tendons in the right eye with minimally hyperintensity on fat-saturated T2-weighted image (Figure 2). A preliminary diagnosis of IOP was made, although it is rare in a child. The child was decided to be treated with intravenous high-dose steroids before considering a biopsy. She began to show signs of clinical improvement, including reduced proptosis and ptosis within 36 hours after starting high-dose steroid treatment. She continued with intravenous high-dose steroids for 3 full days before she was discharged on a gradually tapering dose of oral prednisone. Two weeks after initial examination, follow-up orbital MRI demonstrated a reduction in the size and contrast enhancement of effected muscles in postgadolinium fat-saturated T1-weighted images (Figure 3).


Myositic type of idiopathic orbital pseudotumor in a 4-year-old child: a case report.

Bakan S, Bakan AA, Cingu AK, Beker Acay M, Gocmez A, Elbeyli A, Sencer S - Case Rep Med (2012)

© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3376481&req=5

Mentions: A previously healthy and normally developing 4-year-old girl presented to our pediatric clinic with a 2-day history of painless, gradually progressing ptosis and swollen right eyelid. Visual acuity was 20/20 in her both eyes. Ophthalmological examination of the patient was normal other than upper eyelid ptosis, proptosis, and ophthalmoplegia in the right eye. She was not able to use her left leg and left arm at admission. For this reason, cranial computed tomography (CT) was performed to check for intracranial hemorrhage or mass and turned out to be normal. Complete blood count, electrolyte levels, and sedimentation rate were in normal ranges. There was no atypical cell in peripheral blood smear. In orbital MRI examination, postgadolinium fat-saturated T1-weighted images revealed marked contrast enhancement of medial (Figure 1(a)) and inferior rectus (Figure 1(b)) muscles. MRI also showed enlargement of superior, inferior, and medial rectus muscles and their tendons in the right eye with minimally hyperintensity on fat-saturated T2-weighted image (Figure 2). A preliminary diagnosis of IOP was made, although it is rare in a child. The child was decided to be treated with intravenous high-dose steroids before considering a biopsy. She began to show signs of clinical improvement, including reduced proptosis and ptosis within 36 hours after starting high-dose steroid treatment. She continued with intravenous high-dose steroids for 3 full days before she was discharged on a gradually tapering dose of oral prednisone. Two weeks after initial examination, follow-up orbital MRI demonstrated a reduction in the size and contrast enhancement of effected muscles in postgadolinium fat-saturated T1-weighted images (Figure 3).

Bottom Line: It is the third most common orbital disease after thyroid orbitopathy and lymphoproliferative disorder.This paper describes a 4-year-old girl who presented with sudden ptosis in the right eye and swollen eyelid.She recovered completely with high-dose steroid therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Viransehir State Hospital, 63100 Sanliurfa, Turkey.

ABSTRACT
Idiopathic orbital pseudotumor is a benign, noninfectious, and nonneoplastic disease with unknown cause. It is the third most common orbital disease after thyroid orbitopathy and lymphoproliferative disorder. Idiopathic orbital pseudotumor is extremely rare in pediatric age group and may cause real diagnostic problems. This paper describes a 4-year-old girl who presented with sudden ptosis in the right eye and swollen eyelid. She recovered completely with high-dose steroid therapy. We report clinical and magnetic resonance imaging findings of orbital myositis, which is a rare subtype of idiopathic orbital pseudotumor in children and needs to be differentiated from other orbital disease especially malignancy.

No MeSH data available.


Related in: MedlinePlus