Orbital apex lesion as the presenting manifestation of sarcoidosis.
A 32-year-old black woman presented with progressive proptosis, diplopia, and optic disc edema of the right eye. A computed tomography scan of the orbit showed a right retroorbital mass. A gallium scan showed increased radiotracer activity in the right retroorbital region. Biopsy of the mass showed non-caseating granulomas that were compatible with sarcoidosis. The patient was treated with systemic steroids, and the proptosis and diplopia resolved. Seven months later, the patient presented with contralateral optic neuropathy. Neuroimaging showed enlargement of the left optic nerve. The patient again responded to systemic steroid treatment and experienced complete restoration of vision. An orbital apex lesion may be the presenting manifestation of sarcoidosis.
Segal
E I
EI
Department of Ophthalmology and Visual Sciences, University of Texas Medical Branch, Galveston 77555, USA.
Tang
R A
RA
Lee
A G
AG
Roberts
D L
DL
Campbell
G A
GA
D000328:Adult; D004172:Diplopia / Q000175:diagnosis / Q000188:drug therapy; D005094:Exophthalmos / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D005710:Gallium Radioisotopes; D005938:Glucocorticoids / Q000627:therapeutic use; D006099:Granuloma / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008775:Methylprednisolone / Q000627:therapeutic use; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000188:drug therapy; D009915:Orbit / Q000000981:diagnostic imaging / Q000473:pathology*; D009916:Orbital Diseases / Q000175:diagnosis* / Q000188:drug therapy; D010211:Papilledema / Q000175:diagnosis / Q000188:drug therapy; D011877:Radionuclide Imaging; D012507:Sarcoidosis / Q000175:diagnosis* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed
D005710:Gallium Radioisotopes; D005938:Glucocorticoids; D008775:Methylprednisolone