A Mass in the Greater Wing of the Sphenoid in a Pediatric Pa
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
A 4-year-old girl with no previous medical or ocular history presented with 10 days of right painless, periorbital swelling and erythema. The patient was previously treated with an oral combination of amoxicillin and clavulanic acid and topical gentamicin therapy without any improvement. The patient’s visual acuity, color vision, and pupillary examination results were within normal limits, and intraocular pressures were 28 mm Hg OD and 20 mm Hg OS.

The extraocular movements and confrontational visual fields were normal. There was right upper and lower eyelid edema with mild erythema and 3 mm of proptosis. The eyelids were nontender to palpation. There was trace vasodilation and chemosis of the conjunctiva in the right eye. The remainder of the slitlamp and dilated fundus examination results were within normal limits. Computed tomography of the orbits and magnetic resonance imaging (MRI) of the brain and orbits showed a large lesion of the right greater wing of the sphenoid bone extending toward the orbital apex with edema and enhancement of the right temporal lobe of the brain (Figure 1).

A positron emission tomographic scan and lumbar puncture were performed, and no other involvement of LCH was identified. After completing several cycles of chemotherapy, the patient improved clinically, and subsequent imaging showed resolution of the lesion.

Source: https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2763355
Like
Comment
Share