DR. ANUREET GILL

DR. SHAKEEN SINGH

Abstract

Orbital pseudotumor is an idiopathic orbital inflammatory syndrome that greatly mimics neoplasms both clinically & on imaging studies, hence will often pose great diagnostic challenge.We present an unusual case of orbital pseudotumor that initially looked akin to 3rd nerve palsy.A 53 yr old female (CA breast patient) presented with a 2 month history of diplopia & restricted ocular movements, consistent with the diagnosis of oculomotor nerve palsy but with retained LPS function.MRI orbit revealed inflammatory changes in MR, SR and IR muscles. Histopathology showed muscle fiber infiltration by polymorphic inflammatory infiltrate. Her symptoms improved drastically after systemic administration of prednisolone & mycophenolate mofetil. Orbital pseudotumor should be strongly suspected & hence ruled out in patients presenting with some atypical features along with 3rd nerve palsy’s signs & symptoms.Appropriate treatment should be initiated timely to avoid permanent restrictive myopathies.