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Papilledema as a diagnostic challenge - report of three cases

100%

Cekić S., Risimić D., Stanković-Babić G., Babić R., Jakšić V., Jovanović I., Đorđević-Jocić J.

Open Medicine

2012

vol. 7

issue 1

100-107

We present three different cases of patients with papilledema: one case with a primary tumour of the optic nerve, and two cases with secondary involvement of the optic nerve (breast carcinoma and non-Hodgkin lymphoma). The visual acuity varies from sudden, painless, decrease of vision, to blurred vision and proptosis on the affected eye. A characteristic ophthalmoscopic examination shows a swollen optic disc and promonence with tortuosity of blood vessels. A fluorescein angiography shows dilated capillaries of the optic disc with leakage in the early phase and diffuse hyperfluorescence during the late phase. A ultrasonography B-scan of the affected eye shows prominent optic nerves with widened optic nerve sheath. An exhaustive history and complete ophthalmological examination are essential for the diagnosis, to which fluorescein angiography, B-scan ultrasonography, ocular coherent tomography, computerized tomography, and magnetic resonance can be used as useful additional tests. Treatment and prognosis depend on the primary process. We emphasize the crucial role of ophthalmologist in the early diagnosis of CNS neoplasia.

Orbital lymphoma mimicking Graves’ ophthalmopathy: a case report

86%

Wolyniak B., Lewczuk A., Obolonczyk L., Majewska H., Sworczak K.

Open Medicine

2011

vol. 6

issue 6

826-829

Orbital tumor is a rare presentation of lymphoma. Unspecific symptoms, local infiltration, chronic progression may mimic other more common orbital diseases and often make the diagnosis difficult. We report a case of orbital non-Hodgkin lymphoma initially diagnosed as Graves’ disease. A 65-year-old woman was admitted to the Department of Endocrinology with a diagnosis of a left eye tumor. On admission, apart from the tumor, exophthalmos and the upper eyelid proptosis were present. The lesion had been observed for two years before hospitalization. Due to the muscle infiltration, as detected on computed tomography scanning and magnetic resonance imaging, Graves’ disease was suggested. The thyroid function was normal. Further diagnosis performed during hospitalization revealed lymphoplasmacytic lymphoma. Lymphoma may manifest as a localized orbital tumor without extraorbital or constitutive symptoms. Rare orbital diseases, among others lymphoproliferations, should be taken into account in the differential diagnosis of exophthalmos.

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2 Open Medicine

1 2012

1 2011

1 Babić R.

1 Cekić S.

1 Jakšić V.

1 Jovanović I.

1 Lewczuk A.

1 Majewska H.

1 Obolonczyk L.

1 Risimić D.

1 Stanković-Babić G.

1 Sworczak K.

1 Wolyniak B.

1 Đorđević-Jocić J.

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Papilledema as a diagnostic challenge - report of three cases

Orbital lymphoma mimicking Graves’ ophthalmopathy: a case report