AIM:To assess the clinical presentations and outcomes of idiopathic orbital inflammatory pseudotumor(IOIP)patients with orbital wall bone destruction(OWBD)and to propose an expanded classification system that includes...AIM:To assess the clinical presentations and outcomes of idiopathic orbital inflammatory pseudotumor(IOIP)patients with orbital wall bone destruction(OWBD)and to propose an expanded classification system that includes bone destruction.METHODS:The study retrospectively reviewed clinical presentations,imaging findings,treatment modalities,and outcomes of six patients diagnosed histopathologically with IOIP and OWBD at the Beijing Tongren Hospital,Capital Medical University between October 2018 and June 2021.RESULTS:Over two years,6(10%)of 60 IOIP patients at our hospital exhibited OWBD,but this may overrepresent severe cases.The cohort consisted of three men and three women,aged 17 to 60y(mean 35.5±16.1y).Presenting symptoms included proptosis,eyelid swelling,decreased visual acuity with pain,and palpable mass.Imaging revealed multiple anatomical structures involved with the medial wall being the most common site of bone destruction.Histopathological examination showed classic type in five patients and sclerosing type in one patient.All patients underwent surgical resection followed by methylprednisolone treatment.Follow-up(mean 30.3±3.1mo)indicated three patients had no recurrence,while others had varying degrees of symptom persistence or recurrence.CONCLUSION:IOIP with bone destruction is a rare but significant subtype that mimics malignancy,leading to potential diagnostic and therapeutic challenges.Our findings suggest that complete surgical resection combined with adjunctive glucocorticoid therapy can yield favorable outcomes.However,larger-scale studies are needed to further optimize therapeutic approaches.展开更多
Purpose: To observe the clinical findings and response to treatment in patients with a diagnosis of idiopathic orbital inflammatory pseudotumor.Methods: 209 idiopathic orbital inflammatory pseudotumor cases seen betwe...Purpose: To observe the clinical findings and response to treatment in patients with a diagnosis of idiopathic orbital inflammatory pseudotumor.Methods: 209 idiopathic orbital inflammatory pseudotumor cases seen between Jan 1, 1978 and Dec 31, 1999 in our hospital were evaluated retrospectively. Results: Of the 209 cases, 118 were male and 91 were female; there were 90 in the right eye, 81 left eye and 38 both eyes. Patients age ranged from 4 to 80 years (mean 44.4). Proptosis (66%), palpable mass (65%), swollen eyelid (55%), increased orbital pressure (55%) and motility restriction (48%) were the five most common presenting signs. According to radiologic and surgical findings, focal mass within orbit was the most frequent subtype (43% ), followed by lacrimal inflammatory pseudotumor (32%), diffuse orbital inflammation (10%), myositis (8%) . Perineuritis (2%), periscleritis(2%), acute inflammation (2%) and eyelid pseudotumor (1%) were rare clinical findings. The response to treatment (with a mean展开更多
Purpose: To explore factors which lead to recurrence of idiopathic orbital inflam-matory pseudotumor (IOIP). Methods: Idiopathic orbital inflammatory pseudotumor in 209 cases between Jan 1, 1978 and Dec 31, 1999 in ou...Purpose: To explore factors which lead to recurrence of idiopathic orbital inflam-matory pseudotumor (IOIP). Methods: Idiopathic orbital inflammatory pseudotumor in 209 cases between Jan 1, 1978 and Dec 31, 1999 in our hospital was evaluated retrospectively. The comparison of clinical and pathological parameters between patients with at least one episode of recurrence and those with no recurrence at all was performed and analyzed using logistic regression method. Results: Follow-up results (with a mean follow-up time of 3.4 years, ranging from 0.5 year to 21.0 years) showed that the recurrence rate of IOIP was 41%. Sex and proptosis were associated with the recurrence of IOIP. Male gender was more likely to relapse than female counterparts, with the male being 52% and female being 25%. The severer the proptosis is, the higher the rate of recurrence. Among the clinical subtypes of IOIP, the rate of recurrence (17%) in cases with dacryoadinitis was the lowest, followed by anterior local orbital mass (44%), posterior orbital mass (54%), myositis (75%) and diffuse subtype (100%). However, the clinical subtypes did not show significant relationship with the recurrence of IOIP. Conclusions: Male gender and severe proptosis are associated with a higher recurrent rate in patients with IOIP.展开更多
基金Supported by Beijing Natural Science Foundation(No.7222025)Beijing Science and Technology Rising Star Program Cross-cooperation(No.20220484218).
文摘AIM:To assess the clinical presentations and outcomes of idiopathic orbital inflammatory pseudotumor(IOIP)patients with orbital wall bone destruction(OWBD)and to propose an expanded classification system that includes bone destruction.METHODS:The study retrospectively reviewed clinical presentations,imaging findings,treatment modalities,and outcomes of six patients diagnosed histopathologically with IOIP and OWBD at the Beijing Tongren Hospital,Capital Medical University between October 2018 and June 2021.RESULTS:Over two years,6(10%)of 60 IOIP patients at our hospital exhibited OWBD,but this may overrepresent severe cases.The cohort consisted of three men and three women,aged 17 to 60y(mean 35.5±16.1y).Presenting symptoms included proptosis,eyelid swelling,decreased visual acuity with pain,and palpable mass.Imaging revealed multiple anatomical structures involved with the medial wall being the most common site of bone destruction.Histopathological examination showed classic type in five patients and sclerosing type in one patient.All patients underwent surgical resection followed by methylprednisolone treatment.Follow-up(mean 30.3±3.1mo)indicated three patients had no recurrence,while others had varying degrees of symptom persistence or recurrence.CONCLUSION:IOIP with bone destruction is a rare but significant subtype that mimics malignancy,leading to potential diagnostic and therapeutic challenges.Our findings suggest that complete surgical resection combined with adjunctive glucocorticoid therapy can yield favorable outcomes.However,larger-scale studies are needed to further optimize therapeutic approaches.
文摘Purpose: To observe the clinical findings and response to treatment in patients with a diagnosis of idiopathic orbital inflammatory pseudotumor.Methods: 209 idiopathic orbital inflammatory pseudotumor cases seen between Jan 1, 1978 and Dec 31, 1999 in our hospital were evaluated retrospectively. Results: Of the 209 cases, 118 were male and 91 were female; there were 90 in the right eye, 81 left eye and 38 both eyes. Patients age ranged from 4 to 80 years (mean 44.4). Proptosis (66%), palpable mass (65%), swollen eyelid (55%), increased orbital pressure (55%) and motility restriction (48%) were the five most common presenting signs. According to radiologic and surgical findings, focal mass within orbit was the most frequent subtype (43% ), followed by lacrimal inflammatory pseudotumor (32%), diffuse orbital inflammation (10%), myositis (8%) . Perineuritis (2%), periscleritis(2%), acute inflammation (2%) and eyelid pseudotumor (1%) were rare clinical findings. The response to treatment (with a mean
基金The paper was sponsored by the natural science foundationof Guangdong Province (No. 036651 and 010478)
文摘Purpose: To explore factors which lead to recurrence of idiopathic orbital inflam-matory pseudotumor (IOIP). Methods: Idiopathic orbital inflammatory pseudotumor in 209 cases between Jan 1, 1978 and Dec 31, 1999 in our hospital was evaluated retrospectively. The comparison of clinical and pathological parameters between patients with at least one episode of recurrence and those with no recurrence at all was performed and analyzed using logistic regression method. Results: Follow-up results (with a mean follow-up time of 3.4 years, ranging from 0.5 year to 21.0 years) showed that the recurrence rate of IOIP was 41%. Sex and proptosis were associated with the recurrence of IOIP. Male gender was more likely to relapse than female counterparts, with the male being 52% and female being 25%. The severer the proptosis is, the higher the rate of recurrence. Among the clinical subtypes of IOIP, the rate of recurrence (17%) in cases with dacryoadinitis was the lowest, followed by anterior local orbital mass (44%), posterior orbital mass (54%), myositis (75%) and diffuse subtype (100%). However, the clinical subtypes did not show significant relationship with the recurrence of IOIP. Conclusions: Male gender and severe proptosis are associated with a higher recurrent rate in patients with IOIP.
文摘目的观察自拟清热化坚汤联合糖皮质激素治疗眼眶特发性炎性假瘤(IOIP)的临床疗效。方法 2013年1月至2014年1月收集符合纳入标准的30例IOIP患者,采用随机数字表法分为治疗组和对照组,每组各15例。治疗组予中药联合口服糖皮质激素治疗。对照组予单纯口服糖皮质激素治疗。两组治疗半年后比较中医证候积分、临床疗效(眼球突出度、眼压、影像学检查)及复发率的变化差异。结果 (1)临床疗效:治疗组痊愈5例,显效6例,有效2例,无效2例,总有效率86.67%;对照组痊愈2例,显效3例,有效4例,无效6例,总有效率60.00%(Mann-Whitney U检验,Z=-2.081,P=0.037)。治疗组眼球突出度、眼压以及肿块直径的变化值分别为(-4.20±1.08)mm、(-13.73±4.06)mm Hg(1 mm Hg=0.133 k Pa)、(-1.50±0.30)cm;对照组相应数值为(-2.27±0.73)mm、(-8.13±1.41)mm Hg、(-1.21±0.24)cm,其中眼压变化的组间差异有统计学意义(配对t检验,t=-5.05,P<0.001)。(2)中医证侯疗效:治疗组痊愈5例,显效7例,有效3例,无效0例,总有效率100.00%;对照组痊愈1例,显效2例,有效6例,无效6例,总有效率60.00%(Z=-3.353,P=0.010)。(3)复发率:随访半年,治疗组15例,失访1例,复发2例,复发率14.29%(2/14);对照组15例,失访1例,复发7例,复发率50.00%(7/14)(Fisher确切概率法,P=0.103)。结论自拟清热化坚汤联合糖皮质激素治疗IOIP可以明显改善患者的中医症状及临床体征,对降低IOIP复发率亦有一定作用。
文摘患儿因“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。
