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. But, by local growth it can cause bulging of the eye proptosis, double vision diplopia and loss of vision. Orbital pseudotumor occurs more often in the third to sixth decades 5 with no strong sex predilection 4. Idiopathic sclerosing orbital inflammation clinical pharmacy and. Pseudotumor orbital inflammatory syndrome idiopathic. Ridgway, md slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. The full text of this article is available in pdf format. Inflammatory orbital pseudotumor iop, also known as idiopathic orbital pseudotumor, is a benign, noninfective, inflammatory condition of the orbit without systematic or. A case has been reported of an elderly patient with an unexplained unilateral. Idiopathic orbital inflammation radiology reference article. Idiopathic orbital inflammatory disease an overview. Unilateral disease is the rule but bilateral presentations. 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. A 57yearold white female, with a 3month history of headache and right palpebral edema, presented with marked right.
According to one clinical study, the turmeric compound curcumin could be an effective treatment option for this common eye condition. Sclerosing orbital pseudotumor new york eye cancer center. Inflammatory orbital pseudotumor can affect any or all structures within the orbit. Keywords cat, eye, neoplasia, mouth, myofibroblastic sarcoma, pseudotumor proliferation of fibrous tissue in the presence of lymphocytic. Inflammatory orbital pseudotumor iop, also known as idiopathic orbital pseudotumor, is a benign, noninfective, inflammatory condition of the orbit without systematic or locally identifiable. After 8 years of followup, she had recurrence of symptoms and a new evaluation revealed the final diagnosis of orbital pseudotumor.
Mr imaging of orbital inflammatory pseudotumors with. Orbital pseudotumor is a benign condition that accounts for approximately 10% of all orbital mass lesions. Orbital inflammatory syndrome ois, commonly known as inflammatory orbital pseudotumor, is the most common cause of nonthyroidrelated noninfectious orbital disease. Sclerosing orbital pseudotumor can rarely extend into the sinuses, brain, and other orbit. An orbital pseudotumor can have extraorbital extension resulting in widespread clinical symptoms. This paper describes a 4yearold girl who presented with sudden ptosis in. Pdf on jul 1, 2007, v maurya and others published orbital pseudotumor find, read and cite all the research you need on researchgate. 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. Richards abskalka hwroberts fjflint a pseudotumor of the orbit and retroperitoneal fibrosis. Intracranial extension of an idiopathic orbital inflammatory pseudotumor b. Inflammatory orbital pseudotumor with extension beyond the. Idiopathic orbital inflammatory pseudotumor is an inflammatory lesion of the orbit without any recognizable local or systemic causes 2. Bilyk basics description idiopathic orbital inflammatory syndrome iois is a nonspecific inflammation of orbital tissue with no identifiable local or systemic cause. Orbital pseudotumor is a benign intraorbital process confined to the orbit but extra orbital involvement can occur.
Lyme disease is a multisystem organ disease caused by borrelia. 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. The differential diagnosis of a specific pseudotumor and other orbital masses is both perplexing and. Orbital pseudotumor is an uncommon disorder that both radiologically and clinically. Here we report the first case of orbital pseudotumor presenting with intraaxial magnetic resonance imaging mri changes. Orbital pseudotumor is typically characterized by the rapid development of pain, proptosis, and swelling around the eye and orbit in adults. Definitionorbital pseudotumor is the swelling of tissue behind the eye in an area called the orbit. Case report idiopathic orbital inflammatory pseudotumor ioip accompanied with panuveitis.
The orbit is the hollow space in the skull where the eye sits. A 57yearold white female, with a 3month history of headache and right palpebral. Orbital inflammatory pseudotumor is a rare inflammatory condition of unknown cause that may extend intracranially, usually as a duralbased infiltrate. The aim of this study was to verify the myofibroblastic origin of spindle cells in idiopathic orbital inflammatory pseudotumor by immunohistochemical staining. Orbital inflammatory pseudotumor life in spite of ms. Scleral and uveal thickening and enhancement is present in onethird of patients and are thought to be specific signs of orbital pseudotumor. Case report idiopathic orbital inflammatory pseudotumor ioip. Inflammatory pseudotumors of the head and neck in pathology. Intracranial extension of orbital inflammatory 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. Magnetic resonance imaging mri is the best technique for imaging orbital pseudotumor, although mri findings. Orbital pseudotumor uf health, university of florida health. Previous computed tomographic descriptions of the patterns of orbital pseudotumor. Inflammatory orbital pseudotumor is a benign, intraorbital inflammatory process of unknown etiology. Dd include orbital cellulitis, wegener granulomatosis and lymphoma.
The orbit protects the eyeball and the muscles and tissue that surround it. Inflammatory orbital disease msd manual professional edition. Orbital pseudotumor symptoms, diagnosis, treatment. Orbital pseudotumor information mount sinai new york.
Pseudotumor cerebri is a condition in which the pressure around your brain increases, causing headaches and vision problems. It is the third most common orbital disease after thyroid orbitopathy and lymphoproliferative disorder. Veterinary pathology diagnostic features of feline. The inflammatory response can be nonspecific, granulomatous, or vasculitic or due to reactive lymphoid hyperplasia. Mr imaging of orbital inflammatory syndrome, orbital. The types of orbital pseudotumors were a mass in the orbital apex n 3, diffuse form n 2, and myositis n 1. Differentiation of orbital lymphoma from pseudotumor may be challenging at imaging. Orbital pseudotumor, also known as idiopathic orbital inflammation, is a. Orbital pseudotumor also known as idiopathic orbital inflammatory syndrome iois is a benign, noninfective inflammatory condition of the orbit without. It is considered among the most common diseases of the orbit, after the thyroid orbitopathy and the lymphoproliferative disorder.
Unlike a tumor, however, the pseudotumor does not spread and does not invade nearby tissues. 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. To provide an overview of the spectrum of diseases known as idiopathic orbital inflammatory syndrome also known as orbital pseudotumor, with emphasis on. Idiopathic orbital inflammatory ioi disease, refers to a marginated masslike enhancing soft tissue involving any area of the orbit. 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. T1 inflammatory orbital pseudotumor with extension beyond the orbit. Iois can involve any orbital tissue individually or in combination. To demonstrate a variety of mr imaging findings of orbital inflam matory pseudotumors with extraorbital extension. Orbital pseudotumor discussion orbital pseudotumor is the most common primary tumor of the orbits. Case report idiopathic orbital inflammatory pseudotumor. It commonly affects young and obese women, and its. Idiopathic orbital inflammatory pseudotumors ioip are nongranulomatous inflammatory process of the orbit for unknown etiology.
Idiopathic orbital pseudotumor is extremely rare in pediatric age group and may cause real diagnostic problems. N2 purpose to summarize the clinical profile and response to treatment of 4 biopsyproven cases of inflammatory orbital pseudotumor extending beyond the orbit. Orbital inflammation is generally categorized as infectious or noninfectious. Myositic type of idiopathic orbital pseudotumor in a 4year. Intracranial extension of an idiopathic orbital inflammatory. 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 inflammatory pseudotumors ioip are non granulomatous inflammatory process of the orbit for unknown etiology. Infectious etiologies include bacteria and fungi, most often related to sinus disease.
Pseudotumor cerebri is a relatively common pathology that is characterized by intracranial hypertension in the absence of mass lesions. It is among the 3 rd most common orbital diseases along with thyroid orbitopathy and lymphoproliferative disorder and accounts for 510% of orbital processes. Orbital pseudotumor is an uncommon disorder that both radiologically and. It is a chronic condition that acts much like a brain tumor. Iois is a diagnosis of exclusion, made only after other entities have been ruled out. Any information contained in this pdf file is automatically generated from. Myositic type of idiopathic orbital pseudotumor in a 4. 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. On ct, all of the orbital inflammatory pseudotumors were of homogeneous soft tissue density. The name means false brain tumor because its symptoms are similar.
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. A case has been reported of an elderly patient with an unexplained unilateral exophthalmia. Two cases of orbital pseudotumor are described with computed tomographic ct studies showing extension of the pseudotumor beyond the confines of the bony orbit. Pseudotumor cerebri is a brain condition that causes the same symptoms as a brain tumor. Orbital pseudotumors are benign eye growths that mostly occur in adults. Idiopathic orbital inflammatory syndrome, also known as orbital. If you continue browsing the site, you agree to the use of cookies on this website. 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. Orbital pseudotumor is the swelling of tissue behind the eye in an area called the orbit. Orbital pseudotumor is an uncommon disorder that both radiologically and clinically mimics a malignant process or other inflammatory disease, such as graves ophthalmopathy. Pseudotumor cerebri your doctor thinks you may have pseudotumor cerebri. Igg4related disease igg4rd encompasses a group of fibroinflammatory conditions recognized in recent times. Pdf to provide an overview of the spectrum of diseases known as idiopathic orbital inflammatory syndrome also known as orbital.
The authors used ct and mr to diagnose ioip and demonstrate the presence of. Intracranial extension and bone destruction in orbital. It is a hypocellular lymphoid lesion, often incompletely replacing the orbital fat, lacrimal gland and extraocular muscles in which mature. The files of the orbital center amsterdam from the period. Three cases of surgically proved pseudotumor of the orbital apex with intracranial extension occurred. 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. Dd include orbital cellulitis, wegener granulomatosis and. Idiopathic orbital pseudotumor is a benign, noninfectious, and nonneoplastic disease with unknown cause. Inflammatory orbital disease is a benign spaceoccupying inflammation involving orbital tissues.
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. Documented orbital lyme disease both before and after treatment. This is a condition in which high pressure inside your head can cause problems with vision and headache. 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. Clinically, orbital pseudotumor has been categorized as myositis, dacryoadenitis, anterior. The orbital pseudotumor is often presented in the medical field as the idiopathic orbital inflammatory syndrome abbreviated as iois. 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 orbital pseudotumor accounts for 510% of all the orbital processes. In the setting of an orbital mass with intracranial extension, the possibility of pseudotumor should be considered by the reading radiologist.
470 311 1177 1068 1283 119 1352 381 1221 961 721 1296 1085 1344 300 485 70 1578 832 858 77 1365 618 1190 899 313 1446 346 918