Inflammatory disease of the orbit: A case series

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 tomography scan, revealing intense metabolic activity in the orbit despite the absence of clinical symptoms. Given the impracticability of biopsy, treatment with anti-CD20 was proposed, yielding a favorable radiological response. The third case describes an inflammatory orbital pseudotumor revealed by hemolytic anemia, with improved clinical and biological parameters observed over a 6-month period.