Masquerading Orbital Sarcoidosis with Isolated Extraocular Muscle Involvement
Jane S. Kim1, Richard L. Scawn1, Bradford W. Lee1, Jonathan H. Lin1, 2, Bobby S. Korn1, 3, Don O. Kikkawa1, 3, *
Identifiers and Pagination:Year: 2016
First Page: 140
Last Page: 145
Publisher ID: TOOPHTJ-10-140
Article History:Received Date: 5/5/2015
Revision Received Date: 26/10/2015
Acceptance Date: 26/10/2015
Electronic publication date: 29/04/2016
open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
Two patients, previously diagnosed and treated for euthyroid, autoantibody-negative thyroid eye disease, presented with active orbitopathy. An atypical disease course and presentation prompted orbital biopsy. Extraocular muscle histopathology demonstrated noncaseating granulomatous inflammation consistent with presumed orbital sarcoidosis involving multiple extraocular muscles, including the inferior oblique in one of the cases. These two cases emphasize the importance of a broad differential diagnosis and the utility of an orbital biopsy in the context of an unusual disease presentation or poor treatment response. The patients’ clinical course is discussed alongside important clinical signs, imaging findings, and biopsy results that support a diagnosis of isolated orbital sarcoidosis.