True Pseudotumors and “Pseudo” – Pseudotumors: A Case Series

Objective: To characterize the clinical and pathological features of 4 patients with histopathology-confirmed idiopathic orbital inflammatory disease (OID) initially diagnosed as an orbital neoplasm and 9 patients with histopathology-confirmed orbital neoplasm that presented as idiopathic OID. Me...

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Main Authors: Maria Donna Damo Santiago, MD, MBA, Andrei Paolo S. Angbue-Te, MD
Format: Article
Language:English
Published: Philippine Academy of Ophthalmology 2019-12-01
Series:Philippine Journal of Ophthalmology
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Online Access:https://paojournal.com/index.php/pjo/article/view/132
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author Maria Donna Damo Santiago, MD, MBA
Andrei Paolo S. Angbue-Te, MD
author_facet Maria Donna Damo Santiago, MD, MBA
Andrei Paolo S. Angbue-Te, MD
author_sort Maria Donna Damo Santiago, MD, MBA
collection DOAJ
description Objective: To characterize the clinical and pathological features of 4 patients with histopathology-confirmed idiopathic orbital inflammatory disease (OID) initially diagnosed as an orbital neoplasm and 9 patients with histopathology-confirmed orbital neoplasm that presented as idiopathic OID. Methods: The medical records of 13 patients with orbital mass were reviewed. All biopsies were performed by one orbit surgeon. Results: There were 4 patients in the histopathology-confirmed idiopathic OID group with preoperative diagnosis of orbital neoplasm. Mean age at presentation was 27 years. Follow-up period ranged from 6 to 41 months. The left orbit was predominantly involved (3/4). The presenting symptoms and signs included proptosis (2/4), diplopia (1/4), and inflammation (1/4). The preoperative best-corrected decimal acuity mean was 0.92. Three of 4 patients retained their preoperative visual acuity postoperatively. There was recurrence of inflammatory signs in only 1 patient, which responded well to oral corticosteroids. In the histopathology-confirmed orbital neoplasm with preoperative diagnosis of idiopathic OID group, there were 9 patients with mean age at presentation of 52 years. Follow-up period averaged 7.5 months (range: 0.5 - 83 months). The presenting symptoms and signs included proptosis (4/9), inflammation (3/9), orbital pain (1/9), and epiphora (1/9). The preoperative best-corrected decimal acuity mean was 0.78. Histopathology and immunohistochemistry of the orbital masses revealed malignancy in 80% (7/9) of these cases. Conclusions: Idiopathic OID remains a diagnostic dilemma for many physicians. A detailed history, comprehensive physical examination, and appropriate radiological evaluation are essential to differentiate OID and non-inflammatory orbital conditions such as neoplasms. Biopsy is recommended when there is poor or equivocal response to steroids or suspicion of orbital malignancy.
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spelling doaj-art-d06d123dc2d047f2aedf90a1d95c63312025-08-20T02:04:49ZengPhilippine Academy of OphthalmologyPhilippine Journal of Ophthalmology0031-76592019-12-014427585132True Pseudotumors and “Pseudo” – Pseudotumors: A Case SeriesMaria Donna Damo Santiago, MD, MBA0Andrei Paolo S. Angbue-Te, MD1Department of Ophthalmology, Far Eastern University-Nicanor Reyes Memorial Foundation (FEU-NRMF), Quezon City, Philippines; Department of Ophthalmology, Makati Medical Center, Makati City, Philippines; Department of Ophthalmology, St. Luke’s Medical Center, Quezon City, PhilippinesDepartment of Ophthalmology, Far Eastern University-Nicanor Reyes Memorial Foundation (FEU-NRMF), Quezon City, Philippines; Department of Ophthalmology, Metropolitan Medical Center, Manila, PhilippinesObjective: To characterize the clinical and pathological features of 4 patients with histopathology-confirmed idiopathic orbital inflammatory disease (OID) initially diagnosed as an orbital neoplasm and 9 patients with histopathology-confirmed orbital neoplasm that presented as idiopathic OID. Methods: The medical records of 13 patients with orbital mass were reviewed. All biopsies were performed by one orbit surgeon. Results: There were 4 patients in the histopathology-confirmed idiopathic OID group with preoperative diagnosis of orbital neoplasm. Mean age at presentation was 27 years. Follow-up period ranged from 6 to 41 months. The left orbit was predominantly involved (3/4). The presenting symptoms and signs included proptosis (2/4), diplopia (1/4), and inflammation (1/4). The preoperative best-corrected decimal acuity mean was 0.92. Three of 4 patients retained their preoperative visual acuity postoperatively. There was recurrence of inflammatory signs in only 1 patient, which responded well to oral corticosteroids. In the histopathology-confirmed orbital neoplasm with preoperative diagnosis of idiopathic OID group, there were 9 patients with mean age at presentation of 52 years. Follow-up period averaged 7.5 months (range: 0.5 - 83 months). The presenting symptoms and signs included proptosis (4/9), inflammation (3/9), orbital pain (1/9), and epiphora (1/9). The preoperative best-corrected decimal acuity mean was 0.78. Histopathology and immunohistochemistry of the orbital masses revealed malignancy in 80% (7/9) of these cases. Conclusions: Idiopathic OID remains a diagnostic dilemma for many physicians. A detailed history, comprehensive physical examination, and appropriate radiological evaluation are essential to differentiate OID and non-inflammatory orbital conditions such as neoplasms. Biopsy is recommended when there is poor or equivocal response to steroids or suspicion of orbital malignancy.https://paojournal.com/index.php/pjo/article/view/132pseudotumororbital inflammatory diseaseneoplasmbiopsyhistopathology
spellingShingle Maria Donna Damo Santiago, MD, MBA
Andrei Paolo S. Angbue-Te, MD
True Pseudotumors and “Pseudo” – Pseudotumors: A Case Series
Philippine Journal of Ophthalmology
pseudotumor
orbital inflammatory disease
neoplasm
biopsy
histopathology
title True Pseudotumors and “Pseudo” – Pseudotumors: A Case Series
title_full True Pseudotumors and “Pseudo” – Pseudotumors: A Case Series
title_fullStr True Pseudotumors and “Pseudo” – Pseudotumors: A Case Series
title_full_unstemmed True Pseudotumors and “Pseudo” – Pseudotumors: A Case Series
title_short True Pseudotumors and “Pseudo” – Pseudotumors: A Case Series
title_sort true pseudotumors and pseudo pseudotumors a case series
topic pseudotumor
orbital inflammatory disease
neoplasm
biopsy
histopathology
url https://paojournal.com/index.php/pjo/article/view/132
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