Unilateral orbital inflammatory disease mimicking Graves’ orbitopathy: diagnostic and surgical management
Author: Angeliki Tsingouni
Base Hospital / Institution: General Anticancer Oncological Hospital of Athens “Saint Savvas”
ePoster presentation
Abstract ID: 25-530
Purpose
To present a case of unilateral orbital inflammatory disease initially misdiagnosed as Graves’ orbitopathy, emphasizing the diagnostic challenges and the surgical management approach undertaken.
Methods
A 55-year-old female patient presented with progressive unilateral exophthalmos, periorbital edema, and conjunctival injection. Initial clinical evaluation suggested Graves’ orbitopathy; however, thyroid function tests were within normal limits. Orbital MRI revealed an ill-defined mass in the superolateral orbit, prompting an incisional biopsy. Histopathological analysis confirmed idiopathic orbital inflammatory disease. The patient underwent systemic corticosteroid therapy with partial response. Due to persistent symptoms and cosmetic concerns, surgical debulking of the inflammatory mass was performed via a lateral orbitotomy approach.
Results
Postoperative recovery was uncomplicated, with significant reduction in proptosis and periorbital edema. The patient experienced rapid improvement in ocular motility and complete resolution of diplopia, with preserved visual acuity and stable ocular surface integrity. Histopathological analysis confirmed the diagnosis of orbital lymphoma, prompting referral for adjuvant therapy. Given the infiltrative nature of the lesion, the patient was initiated on UV-based immunomodulatory therapy to reduce the risk of local recurrence and improve long-term disease control. At six months, the patient demonstrated stable eyelid position, full extraocular motility, with no evidence of residual or recurrent tumor. Ongoing follow-up and serial imaging are planned to monitor for potential recurrence, ensuring comprehensive long-term management.
Conclusion
Orbital inflammatory diseases can clinically mimic Graves’ orbitopathy, leading to potential misdiagnosis. Comprehensive evaluation, including imaging and histopathological confirmation, is crucial for accurate diagnosis. Surgical intervention can be effective in cases refractory to medical therapy, providing both functional and cosmetic benefits.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Dimitra | Archontouli | General Anticancer Oncological Hospital of Athens “Saint Savvas” |
| Alexandros | Kapsokolis | 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” |
