Tuberculoma of the orbit and lacrimal gland.

Abstract

The three following cases of tuberculoma, one of the orbit and two of the lacrimal gland, are described because of their rarity (Offret, I939; Duke-Elder, I952). Case reportsThe three patients reported below were in good general condition, with no enlargement of the lymph glands, liver, or spleen. Apart from increased lymphocytes the blood count was normal. The urine was free from albumin and sugar. The blood pressure, pulse rate, and body temperature were normal. The faeces showed no parasitic ova. There was no abnormnality of the chest, air passages, abdomen, skin, or bones. The blood Wassermann reaction was negative. There were no septic foci in the body. Skull x rays showed no abnormality of the orbital bones. There was no history of trauma, and no signs of syphilis, sarcoidosis, or Nlikulicz's disease. The tuberculin test was positive.Case I, an obese woman aged 35 years, complained of gradual painless proptosis of the left eye of 6 months' duration.The right eye and fundus were normal, and the visual acuity was 6/6.The left eye showed a forward proptosis of 20 mm. (Hertel) with downwards limitation of ocular movements. The fundus was normal and the visual acuity was 6/9. A hard orbital mass was felt in the lower eyelid extending backwards below the eye into the orbit. When the mass was pressed backwards the globe was made to protrude forwards.The tumour, which was removed through a lower fornix conjunctival incision, measured 2-5 X I-5 x I cm. and was pink, firm, and encapsulated. Histopathological examination showed a granulomatous structure with giant cells (Fig. i) which is characteristic of tuberculoma, but tubercular organisms were not seen.

Ocular tuberculosis misdiagnosed as retinoblastoma: an interesting case

“…The optic nerve or its sheath may be the source of infection; or a posterior tuberculous abscess of the cornea may cause disseminated infection requiring enucleation 7. Clinical presentation of intraocular tuberculosis includes subretinal abscess, granulomatous anterior uveitis with scleral perforation, exudative mass in anterior chamber, and choroidal mass with panuveitis 8…”

Ocular Scrofuloderma with Unilateral Proptosis

“…Aggarwal et al reported 14 cases of eye involvement in tuberculosis from India; none of the cases had scrofuloderma, lacrimal gland involvement, bone erosion, or orbital abscess combined in a single case (5). Lacrimal gland involvement is more commonly seen in adult females in the age group of 35–50 years and is very rare in children (6).…”

“…The bacteria may settle in the intraorbital region and cause periostitis of the orbital margin or tuberculoma of orbital tissue leading to proptosis (5). There can also be an extension to neighbouring structures such as paranasal sinuses, lacrimal gland and lacrimal sac (4,6). Cases of orbital tuberculoma may present as unilateral proptosis, as a unilateral partial or complete superior orbital fissure syndrome, or as an orbital apex syndrome (6).…”

Tuberculous dacryoadenitis in a child

“…Schmoll et al (2009) reported a 14-year-old Scottish teenager with tubercular dacryoadenitis with a rapidly-enlarging orbital mass. Isolated involvement of the lacrimal gland has also been described (Mortada et al 1971). It may be seen either in the form of lacrimal gland enlargement or abscesses.…”