Bilateral sclerosing orbital pseudotumour in an adult

Abstract

Sclerosing pseudotumour of the orbit is a rare idiopathic chronic inflammatory process, which greatly mimics neoplasms both clinically and on imaging studies. It is therefore important to differentiate this entity from true neoplasms and to rule out any systemic associations. We present a rare case of sclerosing orbital pseudotumour in an adult man with no systemic illnesses who presented with painless progressive proptosis of both eyes and showed a gradual initial response to steroid therapy but relapsed after a 2-year interval.

Figure 1

(A and B) Axial and coronal postcontrast CT sections (Philips Brilliance 64 slice CT scanner using 60 mL of intravenous contrast, omnipaque—300 mgI/mL) showing minimally enhancing retrobulbar mass in the intraconal compartment bilaterally. There is no extraocular muscle involvement. No bone destruction seen.

Figure 2

(A–C) Axial T1-weighted (T1W), T2-weighted (T2W) and coronal STIR images (GE 1.5 T scanner, T1—TE-9 TR-360, T2—TE-103 TR-4400, STIR—TE-83 TR-6280) showing bilateral retrobulbar lesion (arrows) which are hypoisointense on T1W and hypointense on T2W and STIR sequence. The optic nerves (arrowheads) are encased by the mass. No intracranial extension was seen. (D) T1W postcontrast sequence showing significant contrast enhancement. STIR, short tau inversion recovery.