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Rapid resolution of orbital pseudotumor treatment by orbital radiotherapy
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RAPID RESOLUTION OF ORBITAL PSEUDOTUMOR TREATMENT BY ORBITAL RADIOTHERAPY Sarah S. Donaldson, M.D. I. Ross McDougall, M.D. Joseph P. Kriss, M.D. Peter R. Egbert, M.D.
From the Department of Radiology, Divisions of Radiotherapy and Nuclear Medicine, and the Department of Surgery, Division of Ophthalmology, Stanford University Medical Center, Stanford, California 94305 Orbital pseudotumor is a non-specific chronic inflammatory condition which can cause proptosis, periorbital soft-tissue swelling, inflammatory signs and impairment of eye movement and function. Histologically there is diffuse infiltration of lymphocytes. The condition may be unilateral, or bilateral, and the lesions vary in their numbers and location within the orbit. It may mimic Graves' disease clinically but the C.T. findings are different and usually characteristic. Recurrence of the clinical features occur frequently after surgical excision and high dose oral corticosteroid therapy causes side effects. We have used orbital radiotherapy to treat four male patients with orbital pseudotumors (ages 40, 67, 50 and 65). Three patients had bilateral involvement and all four had characteristic C.T. appearance of pseudotumors. Three had biopsy proven disease; biopsy in one patient was unsatisfactory. There was no evidence of an alternative diagnosis, or systemic disease. Treatment was 2000 rads fractionated over 10 days. Each patient experienced a dramatic and rapid improvement in symptoms and signs. Exophthalmometry measurements improved by 8, 8, and 5 nm respectively in those with bilateral disease and 6 mm in the unilateral case. There has been no recurrence after a mean follow-up of 26 months (range lo-32 months). Orbital radiotherapy of pseudotumors appears to be a preferable alternative to surgical or steroid treatments. Because of the variability in presentation radiotherapy must be individualized so that lesions in all orbital sites are effectively treated.
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THE ROLE OF RADIATION. THERAPY IN THE MANAGEMENT OF INTRAOCULAR LYMPHOMA a,b,c Lawrence Margolis, M.D., Robert W. Fraser, M.D.a Devron Char, M.D.,' Allen Lichter, M.D.d Departments of Radiation Oncologya and Ophthalmology,c University of California, San Francisco, CA 94143 Department of Radiation Oncology, Ralph K. Davies Medical Center San Francisco, CA 94114 Department of Radiation Therapy, Johns Hopkins Hospital Baltimore, MD 21205
Nine patients with intraocular lymphomas were seen in the Departments of Ophthalmology and the Division of Radiation Oncology at UCSF and Ralph K.
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RAPID RESOLUTION OF ORBITAL PSEUDOTUMOR TREATMENT BY ORBITAL RADIOTHERAPY Sarah S. Donaldson, M.D. I. Ross McDougall, M.D. Joseph P. Kriss, M.D. Peter R. Egbert, M.D.
From the Department of Radiology, Divisions of Radiotherapy and Nuclear Medicine, and the Department of Surgery, Division of Ophthalmology, Stanford University Medical Center, Stanford, California 94305 Orbital pseudotumor is a non-specific chronic inflammatory condition which can cause proptosis, periorbital soft-tissue swelling, inflammatory signs and impairment of eye movement and function. Histologically there is diffuse infiltration of lymphocytes. The condition may be unilateral, or bilateral, and the lesions vary in their numbers and location within the orbit. It may mimic Graves' disease clinically but the C.T. findings are different and usually characteristic. Recurrence of the clinical features occur frequently after surgical excision and high dose oral corticosteroid therapy causes side effects. We have used orbital radiotherapy to treat four male patients with orbital pseudotumors (ages 40, 67, 50 and 65). Three patients had bilateral involvement and all four had characteristic C.T. appearance of pseudotumors. Three had biopsy proven disease; biopsy in one patient was unsatisfactory. There was no evidence of an alternative diagnosis, or systemic disease. Treatment was 2000 rads fractionated over 10 days. Each patient experienced a dramatic and rapid improvement in symptoms and signs. Exophthalmometry measurements improved by 8, 8, and 5 nm respectively in those with bilateral disease and 6 mm in the unilateral case. There has been no recurrence after a mean follow-up of 26 months (range lo-32 months). Orbital radiotherapy of pseudotumors appears to be a preferable alternative to surgical or steroid treatments. Because of the variability in presentation radiotherapy must be individualized so that lesions in all orbital sites are effectively treated.
(76)
THE ROLE OF RADIATION. THERAPY IN THE MANAGEMENT OF INTRAOCULAR LYMPHOMA a,b,c Lawrence Margolis, M.D., Robert W. Fraser, M.D.a Devron Char, M.D.,' Allen Lichter, M.D.d Departments of Radiation Oncologya and Ophthalmology,c University of California, San Francisco, CA 94143 Department of Radiation Oncology, Ralph K. Davies Medical Center San Francisco, CA 94114 Department of Radiation Therapy, Johns Hopkins Hospital Baltimore, MD 21205
Nine patients with intraocular lymphomas were seen in the Departments of Ophthalmology and the Division of Radiation Oncology at UCSF and Ralph K.
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