A Case of Isolated Orbital Sarcoidosis

ABSTRACT

PURPOSE: The authors report a case of orbital sarcoidosis without evidence of systemic involvement. CASE SUMMARY: A 33-year-old female had a 1 month history of erythematous eyelid swelling. On physical examination, a firm and non-tender mass was observed diffusely along the upper, lower and medial canthal areas. A computed tomography (CT) scan showed a diffuse mass in the anterior orbit. We performed an incisional biopsy and histopathological examination revealed non-caseating granulomas and no evidence of a foreign body. Acid-fast-bacilli (AFB), methenamine silver and periodic-acid-schiff (PAS) stain showed no evidence of infection and chest radiograph was normal. Polymerase chain reaction (PCR) and interferon gamma secretion test showed no evidence of tuberculosis. Antinuclear antibody (ANA) and antineutrophil cytoplasmic antibody (ANCA) were negative and angiotensin converting enzyme (ACE) was within the normal range. Further systemic evaluations were compatible with a diagnosis of orbital sarcoidosis and oral prednisone was prescribed. Six weeks later, the erythematous eyelid swelling had disappeared and there was no evidence of recurrence to date.