title: Idiopathic sclerosing orbital inflammation with intranasal extension.
abstract: 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.
authors.affiliation: Oculoplastic and Orbital Service, University Hospital La Paz, Madrid, Spain. msorgaz@gmail.com
authors.forename: Margarita Sánchez
authors.initials: MS
authors.lastname: Orgaz
authors.forename: Anna
authors.initials: A
authors.lastname: Grabowska
authors.forename: Elena Collantes
authors.initials: EC
authors.lastname: Bellido
authors.forename: Mercedes Patrón
authors.initials: MP
authors.lastname: Romero
authors.forename: Alvaro Arbizu
authors.initials: AA
authors.lastname: Duralde
authors.forename: Ricardo Romero
authors.initials: RR
authors.lastname: Martín
mesh_terms: 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
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone