Primary localized amyloidosis presenting as diffuse amorphous calcified mass in both orbits: case report

Primary localized amyloidosis is rare in the orbit. We report the case of a 63-year-old woman that presented with bilateral proptosis and ophthalmoplegia. A computed tomography scan revealed an infiltrative amorphous and markedly calcified mass in both orbits while a magnetic resonance scan showed a...

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Bibliographic Details
Main Authors: Allan Christian Pieroni Gonçalves, Rodrigo Bernal da Costa Moritz, Mário Luiz Ribeiro Monteiro
Format: Article
Language:English
Published: Conselho Brasileiro de Oftalmologia 2011-10-01
Series:Arquivos Brasileiros de Oftalmologia
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492011000500015&lng=en&tlng=en
Description
Summary:Primary localized amyloidosis is rare in the orbit. We report the case of a 63-year-old woman that presented with bilateral proptosis and ophthalmoplegia. A computed tomography scan revealed an infiltrative amorphous and markedly calcified mass in both orbits while a magnetic resonance scan showed a heterogeneous hypointense signal on T2-weighted images. A biopsy was performed through an anterior orbitotomy. Microscopy revealed extracellular amorphous and eosinophilic hyaline material which stained pink with Congo red and displayed green birefringence on polarized microscopy, leading to a diagnosis of amyloidosis. The results of the systemic workup were completely normal. A two-year follow-up period without any treatment disclosed no worsening of the condition. While calcification of nonvascular orbital lesions has often been regarded as suggestive of malignant disease, our case is a reminder that it can also be a characteristic presenting sign of orbital amyloidosis.
ISSN:1678-2925