Mahr Michael A, Salomao Diva R, Garrity James A
Department of Ophthalmology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Am J Ophthalmol. 2004 Sep;138(3):396-400. doi: 10.1016/j.ajo.2004.04.026.
To summarize the clinical profile and response to treatment of 4 biopsy-proven cases of inflammatory orbital pseudotumor extending beyond the orbit.
Retrospective observational case series.
Four patients' charts were retrospectively reviewed. There were three men with extraorbital extension (two intracranial; one maxillary antrum) and one woman with intracranial disease that extended into the orbit. The men were 40, 41, and 60 years old; the woman was 73 years old.
Two men with orbital myositis and mild discomfort, initially treated with corticosteroids, had asymptomatic intracranial disease 9 and 12 months after initial presentation. A third man had extension into the maxillary antrum after initial symptoms of painless diplopia. The woman had intraorbital disease with minimal discomfort (dacryoadenitis and myositis) 5 years after presenting with intracranial disease in the Meckel cave that subsequently became bilateral. Histopathologic examination in all cases showed nonspecific inflammation without evidence of vasculitis or granulomas.
Unlike typical cases of nonspecific orbital inflammation, two of these four cases did not have pain as a prominent feature. Neuroimaging was essential in diagnosing asymptomatic extraorbital disease. Surgery has a prominent role in confirming this diagnosis, primarily by helping to rule out other diseases, such as those with granulomatous inflammation or vasculitis. Additional therapy was usually not required postoperatively.
总结4例经活检证实的炎症性眶假瘤超出眼眶范围的临床特征及治疗反应。
回顾性观察病例系列。
对4例患者的病历进行回顾性分析。3例男性患者存在眶外扩展（2例扩展至颅内；1例扩展至上颌窦），1例女性患者颅内病变扩展至眼眶。男性患者年龄分别为40岁、41岁和60岁；女性患者73岁。
2例患有眼眶肌炎且有轻度不适的男性患者，最初接受皮质类固醇治疗，初次就诊后9个月和12个月出现无症状颅内病变。第3例男性患者在出现无痛性复视初始症状后病变扩展至上颌窦。该女性患者在Meckel腔出现颅内病变5年后出现眶内病变，不适轻微（泪腺炎和肌炎），随后病变变为双侧性。所有病例的组织病理学检查均显示为非特异性炎症，无血管炎或肉芽肿证据。
与非特异性眼眶炎症的典型病例不同，这4例病例中有2例没有以疼痛为突出特征。神经影像学检查对于诊断无症状眶外病变至关重要。手术在确诊中起重要作用，主要是通过帮助排除其他疾病，如肉芽肿性炎症或血管炎等疾病。术后通常无需额外治疗。
