Orbital Pseudotumor Can Mimic Graves’ Ophthalmopathy

Abstract

context. Orbital pseudotumor (OP) is a benign inflammatory process of the orbit with a large polymorphous lymphoid infiltrate, associated with fibrosis in variable amounts, localized or diffuse. Graves' ophthalmopathy (GO) is the most common cause of proptosis, unilateral or bilateral. case report. We report a patient with unilateral proptosis who was initially treated with antithyroid drugs for an euthyroid Graves disease, but the extension of the investigation infirmed this. The MRI findings (inflammation of fat, muscle and the left lacrimal gland) in conjunction with the biopsy infirmed the initial diagnostic and confirmed the OP. conclusions. Orbital pseudotumor is a rare disorder that can image and clinically mimics some inflammatory disease especialy Graves' ophthalmopathy. Orbital MRI represents the most important test for diagnostic. A negative TRAb in euthyroid cases of proptosis can be a serious starting point for investigating an OP.

The Efficiency of Pulse Therapy with Glucocorticoids in Inflammatory Orbital Disorders: Case Report

“…Similar cases have been described in specialized literature, including a case in our clinic published in 2016, referring to a patient with unilateral ocular modifications and thyroid dysfunction, initially diagnosed with GO, but later established as orbital pseudotumour, due to repeated negative TRAb values, MRI results, and orbital biopsy which confirmed the OP aspect. (16) Systemic glucocorticoids are the main therapy in orbital pseudotumor, as well as the first choice of treatment in moderate and severe Graves ophthalmopathy, due to their antiinflammatory and immunosuppressive effects, with a prompt response and better tolerability when administered intravenously. (9,17) Numerous studies on the efficiency of oral and intravenous corticotherapy have been performed over time and have proved the importance of this therapeutic method.…”

Clinical Characteristics of Idiopathic Orbital Inflammation Syndrome in Relation to Intraocular Pressure

“…Blood tests measuring IgG4, interleukin 2 receptor, thyroid autoantibodies (thyroid-stimulating hormone, receptor antibodies, anti-thyroid peroxidase antibodies, and anti-thyroglobulin antibodies), blood counts, C-reactive protein, angiotensin-converting enzyme, Serine proteinase 3-anti-neutrophil cytoplasmic antibody, and myeloperoxidase-anti-neutrophil cytoplasmic antibody were performed. We investigated the possibility of diseases such as lymphoma, thyroid eye disease, 16 orbital cellulitis, 17 ANCA-related vasculitis, 18 , 19 and sarcoidosis. 20 , 21 We confirmed the presence of dilatation of the superior ophthalmic vein, the presence of an orbital mass on MRI, and the presence of diseases such as orbital tumors and carotid-cavernous fistulae.…”