Page 116 - TD-3-1

Tumor Discovery

CASE SERIES
Inflammatory disease of the orbit: A case series

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1
Meliani Kaoutar *, Rhandour Widad , Bouardi Nizar , Maaroufi Mustapha ,
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Khammar Zineb , and Berrady Rhizlane *
1†
1†
1 Department of Internal Medicine and Onco Hematology, CHU Hassan II Fez, Fez, Morocco
2 Department of Radiology, Chu Hassan II Fez, Fez, Morocco
Abstract

Inflammatory orbital pseudotumors are a heterogeneous group of diseases
characterized by their sensitivity to corticosteroid treatment regardless of the
underlying etiology. Histological examination is generally performed following a
lack of response to steroids, progressive neurological involvement, or suspicion of
malignancy on radiological imaging. Herein, we report three clinical cases presented
to our internal medicine department. The first case underscores the need for
enucleation of the orbit due to the aggressiveness of orbital pseudotumors. This
first case revealed Takayasu disease in a 39-year-old patient. Following the failure
of corticosteroid therapy, favorable progression was achieved with adalimumab.
Our second case concerns a 49-year-old woman presenting with exophthalmos,
demonstrating rapid improvement in both clinical and biological parameters on
corticosteroid administration. However, despite clinical amelioration, the partial
radiological persistence of the orbital tumor prompted a positron emission
† These authors contributed equally tomography scan, revealing intense metabolic activity in the orbit despite the
to this work. absence of clinical symptoms. Given the impracticability of biopsy, treatment with
*Corresponding authors: anti-CD20 was proposed, yielding a favorable radiological response. The third case
Meliani Kaoutar describes an inflammatory orbital pseudotumor revealed by hemolytic anemia, with
(kaoutar.meliani@usmba.ac.com)
Berrady rhizlane improved clinical and biological parameters observed over a 6-month period.
(Rhizberr@yahoo.fr)
Citation: Kaoutar M, Widad R, Keywords: Inflammatory disease of the orbit; Orbital inflammatory syndrome; Orbital
Nizar B, Mustapha M, Zineb K,
Rhizlane B. Inflammatory disease pseudotumor; Vasculitis; Hemolytic anemia
of the orbit: A case series. Tumor
Discov. 2024;3(1):1792.
https://doi.org/10.36922/td.1792
Received: September 11, 2023 1. Introduction
Accepted: December 28, 2023
Published Online: March 28, 2024 Inflammatory disease of the orbit (IDO) is a disease that affects all elements of the orbit
and its appendages. It was first described by Gleason and subsequently elaborated by
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Copyright: © 2024 Author(s).
This is an Open-Access article other researchers. 2
distributed under the terms of the
Creative Commons Attribution IDO affects individuals across all age groups, representing up to 6% of orbital
License, permitting distribution, disorders and frequently necessitating orbital biopsy procedures. Its differential
3
and reproduction in any medium,
provided the original work is diagnosis encompasses a variety of disorders, including tumors, infections, congenital
properly cited. deformities, trauma, and systemic or local inflammatory diseases. Several systemic
4
Publisher’s Note: AccScience inflammatory disorders are associated with IDO, including giant cell arteritis, Churg-
Publishing remains neutral with Strauss syndrome, Erdheim-Chester disease, histiocytosis X, autoimmune thyroid
regard to jurisdictional claims in
published maps and institutional disease, sarcoidosis, granulomatosis with polyangiitis, Crohn’s disease, systemic lupus
affiliations. erythematosus, and other connective tissue diseases. 5

Volume 3 Issue 1 (2024) 1 https://doi.org/10.36922/td.1792