Wegener's granulomatosis of the orbit: a clinicopathological study of 15 patients.
OBJECTIVE
Wegener's granulomatosis is a granulomatous and necrotizing vasculitis that classically involves the respiratory and renal systems. The goal of the study was to define clinical and pathological characteristics in a subgroup of patients with the changes of Wegener's granulomatosis involving the orbit.


METHODS
Retrospective study.


METHODS
A database search identified 15 patients with the histological changes of Wegener's granulomatosis of the orbit presenting over a 23-year period. A review of the histological specimens, radiological studies, and patient charts was performed. Additional follow-up data were obtained through patient interviews.


RESULTS
Of 15 patients (median age, 54 y) with Wegener's granulomatosis of the orbit identified, the disease was limited to the orbit in 12 patients; 3 patients had additional sinonasal involvement. All patients underwent various surgical procedures followed by medical treatment (cyclophosphamide and prednisone). Specimens showed characteristic histopathological features of Wegener's granulomatosis. Follow-up data were available for 12 patients with a median period of 5 years. In the group with only orbital involvement, none of the patients developed systemic progression of Wegener's granulomatosis. Only one patient had multiple local recurrences and later developed contralateral orbital Wegener's granulomatosis.


CONCLUSIONS
Wegener's granulomatosis limited to the orbit is a localized form of the disease without systemic progression. Diagnostic surgical procedures followed by aggressive medical treatment results in good outcome, although local recurrence may occur.
Fechner
Frank P
FP
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston 02144, USA. Frank_Fechner@meei.harvard.edu
Faquin
William C
WC
Pilch
Ben Z
BZ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D011379:Prognosis; D014057:Tomography, X-Ray Computed