Intracranial extension and bone destruction in orbital. Pseudotumor cerebri is a brain condition that causes the same symptoms as a brain tumor. Idiopathic orbital inflammatory pseudotumors ioip are nongranulomatous inflammatory process of the orbit for unknown etiology. Keywords cat, eye, neoplasia, mouth, myofibroblastic sarcoma, pseudotumor proliferation of fibrous tissue in the presence of lymphocytic. Here we report the first case of orbital pseudotumor presenting with intraaxial magnetic resonance imaging mri changes. Intracranial extension of orbital inflammatory pseudotumor.
A case has been reported of an elderly patient with an unexplained unilateral exophthalmia. Any information contained in this pdf file is automatically generated from. Idiopathic orbital inflammatory pseudotumor is an inflammatory lesion of the orbit without any recognizable local or systemic causes 2. Idiopathic sclerosing orbital inflammation clinical pharmacy and. An orbital pseudotumor can have extraorbital extension resulting in widespread clinical symptoms. Mr imaging of orbital inflammatory pseudotumors with.
It is the third most common orbital disease after thyroid orbitopathy and lymphoproliferative disorder. This is a condition in which high pressure inside your head can cause problems with vision and headache. The orbital pseudotumor accounts for 510% of all the orbital processes. Pseudotumor cerebri is a condition in which the pressure around your brain increases, causing headaches and vision problems. Mr imaging of orbital inflammatory syndrome, orbital. Pdf on jul 1, 2007, v maurya and others published orbital pseudotumor find, read and cite all the research you need on researchgate. To demonstrate a variety of mr imaging findings of orbital inflam matory pseudotumors with extraorbital extension. Sclerosing orbital pseudotumor new york eye cancer center. Inflammatory orbital disease msd manual professional edition. Dd include orbital cellulitis, wegener granulomatosis and lymphoma. Definitionorbital pseudotumor is the swelling of tissue behind the eye in an area called the orbit. Intracranial extension of an idiopathic orbital inflammatory. Idiopathic orbital inflammation ioi, also known as orbital pseudotumor and nonspecific orbital inflammation, is an idiopathic inflammatory condition that most commonly involves the extraocular muscles. It is the most common painful orbital mass in the adult population, and is associated with proptosis, cranial nerve palsy tolosahunt syndrome, uveitis, and retinal detachment.
Magnetic resonance imaging mri is the best technique for imaging orbital pseudotumor, although mri findings. Intracranial extension of an idiopathic orbital inflammatory pseudotumor b. Idiopathic orbital inflammatory disease pseudotumor is a nonspecific inflammation involving the orbit. Orbital inflammatory syndrome ois, commonly known as inflammatory orbital pseudotumor, is the most common cause of nonthyroidrelated noninfectious orbital disease. Pseudotumor cerebri your doctor thinks you may have pseudotumor cerebri. Richards abskalka hwroberts fjflint a pseudotumor of the orbit and retroperitoneal fibrosis.
It is a hypocellular lymphoid lesion, often incompletely replacing the orbital fat, lacrimal gland and extraocular muscles in which mature lymphocytes, plasma cells, histiocytes are seen. Inflammatory orbital pseudotumor iop, also known as idiopathic orbital pseudotumor, is a benign, noninfective, inflammatory condition of the orbit without systematic or. Igg4related disease igg4rd encompasses a group of fibroinflammatory conditions recognized in recent times. The orbit protects the eyeball and the muscles and tissue that surround it. It commonly affects young and obese women, and its. Case report idiopathic orbital inflammatory pseudotumor ioip.
Orbital pseudotumor is a benign condition that accounts for approximately 10% of all orbital mass lesions. It is a chronic condition that acts much like a brain tumor. Idiopathic orbital pseudotumor is a benign, noninfectious, and nonneoplastic disease with unknown cause. The differential diagnosis of a specific pseudotumor and other orbital masses is both perplexing and. Orbital pseudotumor is a benign intraorbital process confined to the orbit but extra orbital involvement can occur. Bilyk basics description idiopathic orbital inflammatory syndrome iois is a nonspecific inflammation of orbital tissue with no identifiable local or systemic cause. Orbital pseudotumor, also known as idiopathic orbital inflammation, is a. Orbital pseudotumor is typically characterized by the rapid development of pain, proptosis, and swelling around the eye and orbit in adults. It is among the 3 rd most common orbital diseases along with thyroid orbitopathy and lymphoproliferative disorder and accounts for 510% of orbital processes. Scleral and uveal thickening and enhancement is present in onethird of patients and are thought to be specific signs of orbital pseudotumor. The main clinical features include variable degrees of tissue fibrosis, tumorlike expansions, perivascular lymphocytic infiltration rich in igg4positive plasma cells, and elevated serum igg4. Iois is a diagnosis of exclusion, made only after other entities have been ruled out.
N2 purpose to summarize the clinical profile and response to treatment of 4 biopsyproven cases of inflammatory orbital pseudotumor extending beyond the orbit. Myositic type of idiopathic orbital pseudotumor in a 4year. Noninfectious etiologies are abundant, but often grouped under the heading of orbital pseudotumor or idiopathic orbital inflammation until a specific etiology is elucidated. Iois can involve any orbital tissue individually or in combination. Inflammatory orbital pseudotumor with extension beyond the. Lyme disease is a multisystem organ disease caused by borrelia. Infectious etiologies include bacteria and fungi, most often related to sinus disease. This paper describes a 4yearold girl who presented with sudden ptosis in. Orbital pseudotumor does not spread to other tissues or places in the body.
Documented orbital lyme disease both before and after treatment. In the setting of an orbital mass with intracranial extension, the possibility of pseudotumor should be considered by the reading radiologist. Neo plasms usually cause no pain and no chemosis of the conjunctiva or swelling of the lids, but in over onehalf the cases of pseudotumors these symptoms are present. Orbital inflammatory pseudotumor is a rare inflammatory condition of unknown cause that may extend intracranially, usually as a duralbased infiltrate. Although inflammation is typically confined to the orbit, extraorbital involvement can occur. Orbital pseudotumor also known as idiopathic orbital inflammatory syndrome iois is a benign, noninfective inflammatory condition of the orbit without. Inflammatory pseudotumors of the head and neck in pathology. Inflammatory orbital disease is a benign spaceoccupying inflammation involving orbital tissues. Improvements in diagnostic techniques as also better understanding of the pathology of orbital pseudotumor helped us to define orbital pseudotumor as a nonspecific idiopathic, benign inflammatory process characterized by polymorphous lymphoid infiltrate with varying degrees of fibrosis.
Orbital pseudotumors are benign eye growths that mostly occur in adults. The inflammatory response can be nonspecific, granulomatous, or vasculitic or due to reactive lymphoid hyperplasia. A 57yearold white female, with a 3month history of headache and right palpebral edema, presented with marked right. Idiopathic orbital inflammatory pseudotumors ioip are non granulomatous inflammatory process of the orbit for unknown etiology. Orbital pseudotumor is an uncommon disorder that both radiologically and clinically mimics a malignant process or other inflammatory disease, such as graves ophthalmopathy. Orbital pseudotumor discussion orbital pseudotumor is the most common primary tumor of the orbits. Inflammatory orbital pseudotumor iop, also known as idiopathic orbital pseudotumor, is a benign, noninfective, inflammatory condition of the orbit without systematic or locally identifiable. The aim of this study was to verify the myofibroblastic origin of spindle cells in idiopathic orbital inflammatory pseudotumor by immunohistochemical staining. Inflammatory orbital pseudotumor is a benign, intraorbital inflammatory process of unknown etiology.
Orbital inflammatory pseudotumor life in spite of ms. But, by local growth it can cause bulging of the eye proptosis, double vision diplopia and loss of vision. Three cases of surgically proved pseudotumor of the orbital apex with intracranial extension occurred. Orbital pseudotumor uf health, university of florida health. Orbital inflammatory syndrome orbital pseudotumor ento key. The orbit is the hollow space in the skull where the eye sits. Pseudotumor orbital inflammatory syndrome idiopathic. Dd include orbital cellulitis, wegener granulomatosis and.
Extraorbital extension of orbital pseudotumor in the adjacent paranasal sinuses 810, and into the infratemporal and pterygopalatine fossae 11 has also been rarely reported. Orbital pseudotumor information mount sinai new york. Ultrasound and computed tomographic ct scanning typically shows a diffuse infiltration of the orbit, an inflammation of the eye wall sclera, andor tsign with the optic nerve. Orbital pseudotumor symptoms, diagnosis, treatment.
Inflammatory orbital pseudotumor can affect any or all structures within the orbit. Previous computed tomographic descriptions of the patterns of orbital pseudotumor. A 57yearold white female, with a 3month history of headache and right palpebral. Unlike a tumor, however, the pseudotumor does not spread and does not invade nearby tissues. Case report idiopathic orbital inflammatory pseudotumor. On ct, all of the orbital inflammatory pseudotumors were of homogeneous soft tissue density. Case report idiopathic orbital inflammatory pseudotumor ioip accompanied with panuveitis. The authors used ct and mr to diagnose ioip and demonstrate the presence of. Idiopathic orbital inflammatory pseudotumor ioip with endocranial extension is very unusual. Two cases of orbital pseudotumor are described with computed tomographic ct studies showing extension of the pseudotumor beyond the confines of the bony orbit. A case has been reported of an elderly patient with an unexplained unilateral.
In this report we describe four cases of orbital pseudotumor with extension beyond the orbit. It is a hypocellular lymphoid lesion, often incompletely replacing the orbital fat, lacrimal gland and extraocular muscles in which mature. Clinically, orbital pseudotumor has been categorized as myositis, dacryoadenitis, anterior. Unilateral disease is the rule but bilateral presentations. Idiopathic orbital inflammatory syndrome, also known as orbital.
The orbital pseudotumor is often presented in the medical field as the idiopathic orbital inflammatory syndrome abbreviated as iois. Orbital pseudotumor is an uncommon disorder that both radiologically and clinically. Orbital pseudotumor occurs more often in the third to sixth decades 5 with no strong sex predilection 4. Idiopathic orbital pseudotumor is extremely rare in pediatric age group and may cause real diagnostic problems. Varying degrees of ophthalmoplegia and visual loss were present in all three. Orbital pseudotumor is the swelling of tissue behind the eye in an area called the orbit. In the days before ct and mri scans, doctors who noted swelling of the op tic disc the beginning of the optic nerve in the back of the eye were. If you continue browsing the site, you agree to the use of cookies on this website.
The name means false brain tumor because its symptoms are similar. Sclerosing orbital pseudotumor can rarely extend into the sinuses, brain, and other orbit. Idiopathic orbital inflammatory disease an overview. Veterinary pathology diagnostic features of feline. T1 inflammatory orbital pseudotumor with extension beyond the orbit. Differentiation of orbital lymphoma from pseudotumor may be challenging at imaging. According to upmc university of pittsburgh medical center, orbital inflammatory pseudotumor, or oip, is an inflammatory reaction in the orbital tissues that surround the eyes. Orbital inflammation is generally categorized as infectious or noninfectious. The files of the orbital center amsterdam from the period. Orbital pseudotumor igg4rd is a major cause of orbital inflammatory disease and appears to account for 25 to 50 percent of orbital pseudotumors, including those originally. Pseudotumor cerebri is a relatively common pathology that is characterized by intracranial hypertension in the absence of mass lesions. In one patient with orbital pseudotumor involving the medial rectus muscle, the pseudotumor extended through the medial wall of the orbit into the ethmoid sinus. Idiopathic orbital inflammation radiology reference article.
It is considered among the most common diseases of the orbit, after the thyroid orbitopathy and the lymphoproliferative disorder. Orbital pseudotumor is an uncommon disorder that both radiologically and. The types of orbital pseudotumors were a mass in the orbital apex n 3, diffuse form n 2, and myositis n 1. Idiopathic orbital inflammation, also known as orbital pseudotumor, is defined as a benign, noninfective clinical syndrome characterized by features of nonspecific inflammatory conditions of the orbit without identifiable local or systemic causes.
Idiopathic orbital inflammatory ioi disease, refers to a marginated masslike enhancing soft tissue involving any area of the orbit. Myositic type of idiopathic orbital pseudotumor in a 4. The extraorbital extension of the orbital pseudotumor passed through the superior orbital fissure in all cases, through the inferior orbital fissure in two cases, and through the optic canal in one case. Orbital pseudotumor idiopathic orbital inflammatory disease is a nongranulomatous, acute or subacute inflammatory disease that usually occurs in the anterior orbit or midorbit and often involves the lacrimal gland. The full text of this article is available in pdf format. According to one clinical study, the turmeric compound curcumin could be an effective treatment option for this common eye condition. Orbital pseudotumor is an idiopathic inflammatory condition that usually involves the extraocular muscles although, in some cases there is inflammatory change involving the uvea, sclera, lacrimal gland and retrobulbar soft tissues.
1563 870 891 540 1042 610 1375 1522 796 954 249 49 162 945 186 1074 895 1141 740 434 599 1549 1249 1576 964 542 599 61 435 260 484 408 578 739 1016 1434