Gunasekaran Thiruvarasu, Teow Kheng Leong Kenneth, Tze Hui Pua
Department of Ophthalmology, Hospital Seri Manjung, Sitiawan, MYS.
Department of Ophthalmology, Hospital Bintulu, Bintulu, MYS.
Cureus. 2021 Nov 6;13(11):e19323. doi: 10.7759/cureus.19323. eCollection 2021 Nov.
We report a case of a 43-year-old woman with an underlying right sphenoid wing meningioma (SWM) who complained of increased right eye swelling, proptosis, redness and severe pain for two weeks. Her symptoms started one week after completing radiotherapy. She seeked treatment after a worsening of symptoms. An urgent computed tomography (CT) scan of the brain was done and showed increasing extension of tumour and hypodense areas within intraorbital region of the tumour with intraorbital fat stranding. She was treated as right eye orbital cellulitis with a differential diagnosis of tumour lysis syndrome. She was started on a combination of intravenous antibiotics and improvements were noticed after two days of treatment. This report presents the diagnostic challenge in managing orbital swelling in a patient with sphenoid wing meningioma with inconclusive radiological findings. Orbital cellulitis is an ocular emergency that requires prompt treatment and can potentially be vision and life-threatening, if not addressed early. In such cases with diagnostic dilemma, the decision to treat should be made as early as possible.
我们报告一例43岁女性，患有右侧蝶骨嵴脑膜瘤（SWM），她主诉右眼肿胀、眼球突出、发红并伴有严重疼痛两周。她的症状在完成放疗一周后开始出现。症状加重后她寻求治疗。紧急进行了脑部计算机断层扫描（CT），结果显示肿瘤范围扩大，肿瘤眶内区域出现低密度区，并伴有眶内脂肪条索状改变。她被当作右眼眼眶蜂窝织炎治疗，鉴别诊断为肿瘤溶解综合征。开始给予静脉抗生素联合治疗，治疗两天后症状有所改善。本报告展示了在蝶骨嵴脑膜瘤患者出现眶部肿胀且影像学检查结果不明确时的诊断难题。眼眶蜂窝织炎是一种眼部急症，需要及时治疗，若不及早处理，可能会危及视力和生命。在这种存在诊断困境的病例中，应尽早做出治疗决定。
