Orbital Mass in A 9Year Old Girl by S Rangaraj in surgery and case studies open access journals in lupine publishers.
A 9-year-old girl presented with 4-month history of swelling and discoloration on the right upper eyelid and inability to open the eyes completely (Figure 1). She was previously fit and well with no past medical history of note. She was initially diagnosed with periorbital cellulitis at the local hospital and was treated with antibiotics and antihistamines for four weeks with no improvement. Initial investigations showed elevated platelet count of 508, and raised inflammatory markers - ESR of 67 mm/hr and CRP of 40 mg/L. The CT scan was suggestive of a mass lesion on the upper eyelid (Figure 2). Biopsy done by the ophthalmology team showed soft tissue fibro-inflammatory mass with reactive lymphoid aggregates and dense histiocytic and eosinophilic inflammation centred around variable calibre vessels. No atypical leukemic/ lymphoid infiltrates were seen. Histiocytic cells were positive for CD160 and negative for Langerin. Hence a diagnosis of small vessel vasculitis was suggested. The child was then referred to our tertiary pediatric rheumatology service.
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