A Case of Orbital Pseudotumor

ABSTRACT

The orbital pseudotumor is non-specific inflammatory disease and is unrelated with specific local or systemic disease. The major symptoms are orbital pain, limitation of the ocular movement and exophthalmos. The inflammatory change can be diffuse within the orbit or may involve a specific structure such as an extraocular muscle or lacrimal gland. It occasionally occurs acutely, but chronically in some cases. It may bring about scarring accompanied by the intraorbital soft tissue including retroorbital fat or extraocular muscles. This can be detected by ultrasound, CT orMRI. The findings by imaging procedures are thickened extraocular muscles, diffuse inflammation of intraorbital soft tissue, enlarged lacrimal gland and enhanced periorbital tissue like "a ring". Sometimes, the focal masses may be seen around the optic nerve, within the retroorbital fat or near the opbital periosteum. The diagnosis of pseudotumor is made by excluding other causes or orbital mass lesions, such as neoplasm, and other causes of orbital inflammation such as Graves' disease and local infection. Treatments are usually used systemic high-dose steroids, additionally surgical excision and radiation. Authors experienced a 52-year old female with progressively enlarged tumor in right orbital area, exophthalmos and loss of sight was treated with surgical excision, and then the defect was reconstructed with the radial forearm free flap successfully.