Orbital tumor presenting as chronic conjunctivitis: diagnostic challenges and surgical management
Author: Alexandros Kapsokolis
Base Hospital / Institution: General Anticancer Oncological Hospital of Athens “Saint Savvas”
ePoster presentation
Abstract ID: 25-527
Purpose
To present the diagnostic and surgical management of an orbital tumor initially misdiagnosed as conjunctivitis, highlighting the importance of comprehensive imaging and multidisciplinary collaboration.
Methods
The patient initially presented with symptoms of chronic conjunctival injection, periorbital swelling, and exophthalmos, which were initially attributed to a severe conjunctival inflammation. Despite symptomatic treatment, the condition progressed, leading to a more detailed ophthalmological evaluation. MRI of the orbits revealed a well-defined mass, measuring 26 mm, extending from the posterior aspect to the anterior surface along the medial rectus muscle, displacing the globe without direct optic nerve involvement. Given the tumor’s proximity to the optic nerve and its progressive nature, surgical excision was planned. The surgical procedure included careful dissection to avoid damage to the optic nerve and surrounding critical structures, followed by complete tumor excision and biopsy. Intraoperative findings confirmed a firm, encapsulated mass with clear margins, consistent with the MRI description. Histopathological and molecular analysis were performed to confirm the tumor’s nature and guide further treatment.
Results
Initial postoperative assessments showed mild improvement in proptosis (23 mm), reduction of periorbital edema, and decreased conjunctival chemosis. Follow-up MRI at 2-, 5-, and 7-month post-surgery indicated a gradual decrease in tumor volume. However, some residual mass persisted, infiltrating the anterior portion of the medial rectus muscle without significant optic nerve involvement. The patient remains under close monitoring, pending further oncological evaluation and possible adjuvant therapy.
Conclusion
This case underscores the critical role of advanced imaging in the differential diagnosis of orbital masses and highlights the importance of timely surgical intervention to prevent permanent ocular damage. Multidisciplinary management and long-term follow-up are essential for optimizing patient outcomes in complex orbital pathology.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Dimitra | Archontouli | General Anticancer Oncological Hospital of Athens “Saint Savvas” |
| Angeliki | Tsingouni | General Anticancer Oncological Hospital of Athens “Saint Savvas” |
| Andromachi | Fermanoglou | General Anticancer Oncological Hospital of Athens “Saint Savvas” |
| Nikolaos | Veresiagin | General Anticancer Oncological Hospital of Athens “Saint Savvas” |
| Christos | Trivizas | General Anticancer Oncological Hospital of Athens “Saint Savvas” |
| Ilinka | Mis | General Anticancer Oncological Hospital of Athens “Saint Savvas” |
