[Graves ophthalmopathy with coexisting tumor of the right orbit and hyperprolactinemia--case report].
Ophthalmopathy is a typical manifestation of Graves disease. Although most commonly ophthalmopathy affects both eyes, sometimes it is localized in only one orbit; neoplastic process must be considered then. The coexistence of a tumor of the orbital area and Graves ophthalmopathy is extremely rare. We present a case of a 42-years-old female with bilateral Graves ophthalmopathy, and a coexisting tumor of the right orbit. Magnetic resonance imaging of the orbits revealed a thickening of both rectus inferior extraocular muscles typical for Graves ophthalmopathy. An irregular low-signal mass was observed at the apex of the right orbit; it did not compress the optic nerve. The mass enhanced with gadolinium contrast, with its largest length of 4 cm, height of 2.5 cm, and the largest transverse diameter of 3 cm. It extended along the right trigeminal nerve into the right cavernous sinus, sella turcica, compressed the optic chiasm and penetrated into the right orbital inferior fissure. The tumor infiltrated the dura matter, and surrounded the intracranial part of the right optic nerve but did not cause its compression. Secondary amenorrhoea was present in this patient, probably due to hyperprolactinemia caused by the tumor (the plasma prolactin 1652 ulU/ml, RR 70.00-510.00). The patient was treated with radioiodine for hyperthyroidism and referred to neurosurgeons. Stereotactic therapy and surgery were considered in her case.
Owecki
Maciej
M
Katedra i Klinika Endokrynologii, Przemiany Materii i Chorób Wewnetrznych AM, Poznaniu.
Sowińiski
Jerzy
J
D000328:Adult; D000568:Amenorrhea / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D006111:Graves Disease / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D006966:Hyperprolactinemia / Q000150:complications / Q000175:diagnosis* / Q000209:etiology; D008279:Magnetic Resonance Imaging; D009918:Orbital Neoplasms / Q000150:complications* / Q000175:diagnosis*; D011388:Prolactin / Q000097:blood
D011388:Prolactin