Myositic orbital pseudotumour

Case contributed by Dr Varun Babu

Presentation

Acute onset down gaze diplopia.

Patient Data

Age: 40 years
Gender: Female
MRI

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.

CT

Review contrast enhanced CT scan after 6 weeks and steroid treatment

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.

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Case information

rID: 56897
Case created: 27th Nov 2017
Last edited: 30th Nov 2017
System: Head & Neck
Tags: orbit, eye
Inclusion in quiz mode: Included
Institution: Vivid Diagnostic Centre

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