Year: 2025
Type: article
Study design: Case Report
Abstract: An orbital pseudotumor is a non-neoplastic, inflammatory condition of the orbit, often idiopathic, but possibly autoimmune, triggered by infection or another immune processes.1,8 It's the third most common orbital condition, following thyroid orbitopathy and lymphoproliferative disorder.9 In contrast to adults, paediatric cases typically exhibit a bilateral pattern and constitutional symptoms.Common clinical includes a palpable mass, reduced ocular movement, eyelid swelling, pain, proptosis and increased intraocular pressure.2 Affected tissues include the rectus muscles (myositis), orbital cellulitis and dacryoadenitis.7 Diagnosis involves clinical history, detailed physical, ophthalmological assessments, laboratory investigations and imaging studies including computed tomography (CT) and magnetic resonance imaging (MRI) of the orbit and facial sinuses with contrast enhancement.Open biopsy is recommended when suspicious of malignancy or in poor response to corticosteroid treatment.2,4,5 The differential diagnosis includes any pathology causing an acute orbital condition; however, in children, this entity is most often confused with orbital cellulitis and thyroid eye disease.2,3,5 Oral systemic corticosteroids are the preferred treatment, with rapid improvement being diagnostic.This paper discusses a case of orbital pseudotumor and its management.A 7-year-old female from Angola, living in Portugal presented to the emergency department with a 15day history of left frontal headache causing nighttime awakening, intermittent abdominal pain and vomiting.The patient was diagnosed with streptococcal tonsilitis a month prior.On examination, there was a subtle left proptosis, mild pain with rightward gaze with normal neurological and ophthalmological assessments.There were no other symptoms associated, included diplopia or fever.Brain CT revealed enlargement of the left lateral rectus muscle, suggesting expansive lesion or myositis.After discussion with the ophthalmologist, the child was initially treated with non-steroidal anti-inflammatory drugs (NSAIDs) and re-evaluated in 48 hours.The headache improved, but proptosis persisted, prompting further investigation.Initial laboratory investigation with a complete blood count,
Source: Pediatric Oncall
Authors: Beatriz Luzio Vaz, Maria Limbert, Tania Moreira
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4407275727