Shen Christopher C, Silver Amanda L, O'Donnell Thomas J, Fleming James C, Karcioglu Zeynel A
Hamilton Eye Institute, University of Tennessee, Health Sciences Center, Memphis, Tennessee 38163, USA.
J Neuroophthalmol. 2009 Mar;29(1):50-3. doi: 10.1097/WNO.0b013e3181989adb.
A 48-year-old woman with a history of chronic intranasal cocaine abuse presented with unilateral proptosis associated with severe visual loss from optic neuropathy in the right eye. Imaging showed extensive bone and soft tissue destruction in the paranasal region and an orbital mass. Initial biopsies suggested a low-grade neoplasm. The correct diagnosis was established only on repeat biopsy, which revealed marked pleomorphism and nonspecific chronic inflammation with irregular collagen bundles containing thick-walled blood vessels. This case emphasizes that intranasal cocaine abuse may clinically, radiographically, and histopathologically mimic a neoplasm or a necrotizing vasculitis.
一名48岁有慢性鼻内可卡因滥用史的女性，出现单侧眼球突出，伴有右眼因视神经病变导致的严重视力丧失。影像学检查显示鼻窦区域广泛的骨质和软组织破坏以及一个眼眶肿物。初次活检提示为低度肿瘤。仅在重复活检时才明确了正确诊断，结果显示有明显的多形性以及非特异性慢性炎症，伴有含厚壁血管的不规则胶原束。该病例强调鼻内可卡因滥用在临床、影像学及组织病理学上可能酷似肿瘤或坏死性血管炎。
