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Systemic sarcoidosis initially presenting as an orbital tumour
The European Respiratory Journal
|March 1, 1995
Summary
This case study highlights an unusual presentation of sarcoidosis in a 73-year-old woman. Early diagnosis and treatment of ocular sarcoidosis with systemic involvement led to a favorable outcome.
Area of Science:
- Ophthalmology
- Pulmonology
- Rheumatology
Background:
- Sarcoidosis is a multisystem inflammatory disease characterized by noncaseating granulomas.
- Ocular involvement can be the initial presentation, even without respiratory symptoms.
Observation:
- A 73-year-old woman presented with unilateral red, itchy, and painless proptosis.
- Ocular imaging revealed a postero-ocular mass, biopsy-confirmed as noncaseating granuloma consistent with sarcoidosis.
Findings:
- Thoracic CT showed bilateral hilar and mediastinal adenopathies.
- Gallium scan indicated uptake in hilar regions, left orbit, and right parotid gland.
- Bronchial biopsies and bronchoalveolar lavage (BAL) confirmed active pulmonary sarcoidosis.
Implications:
- This case underscores the importance of a comprehensive systemic evaluation for sarcoidosis, even with isolated ocular symptoms.
- Prompt diagnosis and treatment with corticosteroids (prednisolone) can lead to favorable outcomes in neurosarcoidosis.
- Ophthalmologists and pulmonologists should collaborate in managing complex sarcoidosis cases.