儿童特发性眼眶炎性假瘤1例

Idiopathic orbital inflammatory pseudotumor in a child:A case report

患儿因“左眼红肿12 d”就诊。左上睑红肿(++++),眼眶鼻侧可触及约黄豆大小硬结,界不清,质地中等,压痛(−),伴上睑下垂,遮盖角膜下缘。双眼眼位正,左眼眼球外转轻度受限。眼眶及视神经MRI显示左眼上睑软组织肿胀,考虑炎性改变。入院诊断为左眼特发性眼眶炎性假瘤(Idiopathic orbital inflammatory pseudotumor,IOIP)。予以激素治疗后症状好转且随访期间无复发。本例患儿为拒绝外院活检而就诊于暨南大学附属第一医院的小儿IOIP病例,提示早期规范治疗是降低此病复发率的关键,尤其是儿童患者。

The pediatric patient was referred to our hospital with a 12-day history of left eye redness and swelling.On the orbital and nasal side of the eye,there was a firm,nontender mass about the size of soybeans,with unclear boundary,medium texture.Orbital examination showed left ptosis,covering limbus.Motility examination revealed both eyes were in normal position,and the left eye was slightly limited in extraocular rotation.Magnetic resonance imaging(MRI)revealed evidence of diffuse inflammation of left eyelid,and orbital inflammatory was considered.Excluding other etiologies,the child was diagnosed initially with idiopathic orbital inflammatory.The symptoms improved after hormone therapy and there was no recurrence during follow-up.This case was a case of IOIP in a child who was admitted to the First Affiliated Hospital of Jinan University for refusing biopsy from another hospital.The paper suggests that early standardized treatment is the key to reduce the recurrence rate of this disease,especially in children.