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Updated: Sep 8, 2025

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Hematic Pseudocyst Masquerading as Orbital Cellulitis and Sinusitis.

Ryan Larochelle1, Alexandra Levitt1, Sophie Liao1

  • 1Department of Ophthalmology, University of Colorado, Aurora, Colorado, USA.

Case Reports in Ophthalmology
|June 15, 2022
PubMed
Summary
This summary is machine-generated.

Hematic pseudocysts, collections of blood byproducts near orbital implants, can cause vision problems and mimic infections. Early diagnosis and treatment are crucial for managing these rare orbital complications.

Keywords:
HardwareHematic cystOrbital fracturePseudocyst

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Area of Science:

  • Ophthalmology
  • Plastic Surgery
  • Radiology

Background:

  • Hematic pseudocysts are rare, nonepithelial-lined capsules containing blood byproducts.
  • They typically occur remotely after orbital fracture hardware implantation.
  • Causes include trauma, implant migration, and tissue erosion leading to hemorrhage.

Observation:

  • Risk factors for hematic pseudocysts include inadequate posterior fracture reduction and nonporous implant materials.
  • Clinical presentations can include pain, swelling, proptosis, and vision changes due to mass effect.
  • These lesions are often misdiagnosed as tumors or infections.

Findings:

  • A unique case presented of a hematic pseudocyst mimicking orbital cellulitis and maxillary sinusitis in a patient 2 years post-orbital fracture repair.
  • CT imaging revealed a soft tissue collection adjacent to an implant and sinus opacification.
  • Surgical intervention confirmed the presence of a pseudocyst, which was successfully removed.

Implications:

  • This case highlights the importance of considering hematic pseudocysts in the differential diagnosis of orbital complications, especially after hardware implantation.
  • Proper fracture reduction and material selection may reduce the risk of pseudocyst formation.
  • Accurate diagnosis and timely surgical management are essential for favorable patient outcomes.