Welcome, please sign in
Follow DJO on Facebook Follow DJO on Twitter
Grand Rounds
  Most Recent Cases
  Dates of Case
  Type of Case
  Submit a Grand Round.
  Register with DJO to receive personalized updates.

If you're already a
member, please sign in.
25 year old kickboxer with progressive proptosis
Digital Journal of Ophthalmology 1997
Volume 3, Number 26
September 24, 1997
Printer Friendly

Scott C. Brun, MD | Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
Peter A.D. Rubin, M.D. | Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
Differential Diagnosis
The differential diagnosis can be stratified along either the clinical or radiological findings. The findings of painful proptosis with lid prominence temporally are suggestive of a ruptured dermoid cyst or dacryoadenitis. A lymphangioma with hemorrhage could present in a similar fashion but would tend to be more sudden in onset with skin discoloration. Orbital pseudotumor or granulocytic sarcoma are other possibilities. The discovery of bony erosion on CT raises the question of a malignant process. A metastatic tumor, rhabdomyosarcoma, or adenoid cystic carcinoma are compatible with these findings. Eosinophilic granuloma or aneurysmal bone cyst could present in similar fashion. An orbital abscess could presumably induce an osteomyelitis with bony changes as well. The bony erosion makes some clinical possibilities such as orbital pseudotumor or dacryoadenitis less likely.