Presentation
Acute onset down gaze diplopia.
Patient Data
Initial MRI contrast enhanced study of the orbits revealed isolated bulky right superior rectus with predominant muscle belly involvement and preservation of orbital fat. Diffuse hyprenhancement of the muscle was observed with no other extra ocular muscle nor any other orbital structure involvement.
Review contrast enhanced CT after 6 wk & steroid Rx
Complete resolution of right superior rectus enlargement with return to normal size.
Case Discussion
Isolate myositic orbital pseudotumor always rings in the confusion of, "Is there an underlying neoplasm like lymphoma?" The easiest way to rule out would be to take a muscle biopsy. If you opt to wait and watch, after putting the patient on steroids, as was seen in this case, a complete resolution of the previous findings, as well as clinical symptoms, confirms the initial diagnosis of isolated myositic pseudotumor.
Unable to process the form. Check for errors and try again.