Nonspecific orbital inflammation

Case contributed by Shervin Sharifkashani
Diagnosis almost certain


Left orbital pain, left eye proptosis, preseptal soft tissue swelling, and upper eyelid bulge at the temporal side for two months.

Patient Data

Age: 30 years
Gender: Male

Ill-defined diffuse soft tissue density within the left lacrimal gland extended within the upper eyelid, adjacent superior rectus muscle, lateral rectus muscle, and the space interposed the lateral rectus muscle and orbital bony wall. Left side proptosis and preseptal soft tissue swelling are noted. No obvious bone erosion is seen. The lesion also partially encased the adjacent eye uveo-scleral layer.

Case Discussion

The case illustrates the non-contrast MDCT features of the pathology-proved idiopathic orbital inflammation (IOI) or nonspecific orbital inflammation (NSOI). The disease based on location can be classified as anterior, diffuse, posterior or apical 1. The main differential diagnosis is orbital lymphoma and the corticosteroids are the cornerstone of the treatment but in some cases, chemoradiation can be mandatory.

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