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TitelAtypical inflammatory myofibroblastic pseudotumor of the etmoidal sinus extending into the orbit
DoelTo report a case of an atypical inflammatory pseudotumor of the paranasal sinuses with bony invasion extending into the orbit .
MethodesCase-report.
ResultatenA 71-year old man presented with slowly progressive painless diplopia followed by unilateral proptosis of the left eye with a slight edema of the upper eyelid. Visual acuity was 0.4 with a relative afferent pupillary defect . Abduction and depression of the left eye were limited. Imaging showed an orbital tumor around the obliquus superior with lateral displacement, possible infiltration of the superior and medial rectus, involvement of fossa pterygopalatinum , sinus etmoidalis, sphenoidalis and maxillaris , intracranial extension through the fissura orbitalis superior, bone erosion and sclerotic bone reaction. Endoscopic ethmoïdal, maxillary and orbital biopsies discovered a inflammatory myofibroblastic tumor. Blood parameters showed eosinophily. ANCA and CRP were negative. Discussion: In the literature three cases of orbital myofibroblastic tumors have been described but never with bone invasion. Only a few sinus inflammatory pseudotumors with bony erosion have been reported. Central nervous system myofibroblastic tumors give a dura based mass-forming an en plaque pattern. Two cases with orbital involvement have been described.
ConclusieThis eroding sino-orbital inflammatory myofibroblastic tumor is a new finding mimicking a malignant tumor.
Auteur 1
NaamLAUWERS
InitialenN
InstituutAntwerp University Hospital, Department of Ophthalmology
StadEdegem
Auteur 2
NaamDe Groot
InitialenV
InstituutAntwerp University Hospital, Department of Ophthalmology
StadEdegem
Auteur 3
NaamLeysen
InitialenI
InstituutAntwerp University Hospital, Department of Ophthalmology
StadEdegem
Auteur 4
NaamClaes
InitialenJ
InstituutAntwerp University Hospital
StadEdegem
Auteur 5
NaamDe Keizer
InitialenR
InstituutAntwerp University Hospital, Department of Ophthalmology
StadEdegem
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