Unilateral Eyelid Edema as Initial Sign of Orbital Sarcoidosis.
Introduction. Sarcoidosis is a rare multisystemic granulomatous inflammatory disease of unknown etiology affecting the respiratory system, skin, and eyes. Sarcoidosis outside the lacrimal gland is rare. The case study concerns a patient with a final diagnosis of orbital sarcoidosis. Case Report. A 37-year-old male patient went to the ophthalmic emergency room complaining of pain in the left eye, diplopia, and decreased visual acuity. An external eye examination showed hard and cold edema of the lower eyelid, ocular motility with limitation of adduction, and discreet ipsilateral proptosis. Magnetic resonance of the orbit showed left eye proptosis and thickening and increase of soft tissues associated with heterogeneous impregnation of contrast in the infralateral region of the left eyelid. A biopsy of the lesion showed a chronic inflammatory process, with numerous compact nonnecrotizing granulomas surrounded by lamellar hyaline collagen, providing histological confirmation of sarcoidosis. Discussion. A biopsy of the orbital tumor is essential for the diagnosis of sarcoidosis, in addition to the search for systemic findings such as hilar adenopathy or parenchymal lung disease found in 90% of patients.
Department of Head and Neck Surgery, Hospital Ana Costa, 11050-120 Santos, SP, Brazil.
Sílvia Miguéis Picado
0000-0003-2555-0108
SM
Petrarolha
Universidade Metropolitana de Santos (UNIMES), 11050-120 Santos, SP, Brazil.
Bruna Suda
0000-0002-4655-483X
BS
Rodrigues
Universidade Metropolitana de Santos (UNIMES), 11050-120 Santos, SP, Brazil.
Flávio David Haddad
FD
Filho
Department of Head and Neck Surgery, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, SP, Brazil; Department of Head and Neck Surgery, Hospital Ana Costa, Santos and Irmandade da Santa Casa da Misericórdia, 11050-120 Santos, SP, Brazil.
Rogério Aparecido
RA
Dedivitis
Department of Ophthalmology, Hospital Ana Costa, 11050-120 Santos, SP, Brazil.
Samuel Brunini
SB
Petrarolha
Department of Ophthalmology, Hospital Ana Costa, 11050-120 Santos, SP, Brazil.
Pedro Martins Tavares Scianni
0000-0003-4244-1851
PM
Morais