Idiopathic sclerosing orbital inflammation with intranasal extension.
BACKGROUND
To report a case of idiopathic orbital sclerosing inflammation (ISOI) with intranasal extension.


METHODS
The patient presented with a 6-month history of epiphora, upper eyelid swelling, ptosis and mild orbital pain. Ophthalmologic examination, CT, MRI and biopsy with surgical debulking were performed.


RESULTS
MRI revealed a homogeneously enhancing diffuse right orbital mass in the inferonasal quadrant of the orbit, which extended to the nasal cavity up to inferior nasal concha, maxillary and ethmoid sinuses. Histological analysis showed dense collagenous tissue with sparse infiltration of mixed inflammatory cells. Inmunohistochemical analysis confirmed polyclonality. The diagnosis of idiopathic sclerosing orbital inflammation was made and 80 mg/day of oral prednisolone was prescribed. At last follow up, one year later, there was no clinical evidence of recurrent orbital disease.


CONCLUSIONS
ISOI can present with extraorbital extension. Corticosteroids are a reasonable first-line treatment, until the pathogenesis is better understood.
Orgaz
Margarita Sánchez
MS
Oculoplastic and Orbital Service, University Hospital La Paz, Madrid, Spain. msorgaz@gmail.com
Grabowska
Anna
A
Bellido
Elena Collantes
EC
Romero
Mercedes Patrón
MP
Duralde
Alvaro Arbizu
AA
Martín
Ricardo Romero
RR
D000284:Administration, Oral; D000328:Adult; D003131:Combined Modality Therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013508:Ophthalmologic Surgical Procedures; D009915:Orbit / Q000473:pathology*; D016727:Orbital Pseudotumor / Q000473:pathology* / Q000628:therapy; D010254:Paranasal Sinus Diseases / Q000473:pathology* / Q000628:therapy; D011239:Prednisolone / Q000627:therapeutic use; D012598:Sclerosis; D014057:Tomography, X-Ray Computed
D005938:Glucocorticoids; D011239:Prednisolone