Keywords
Graves’ orbitopathy; Graves’ disease; Mucocoele; Proptosis; Exophthalmos
Abstract
Orbitopathy is an inflammatory disorder affecting orbital and per orbital tissue. It can manifest itself with proptosis. The main cause of proptosis in adults is Graves’ Orbitopathy (GO). Recognition of GO does not exclude other causes of exophthalmos and differential diagnosis is sometimes required. The case presents the patient with Graves Disease (GD), admitted to the Department of Endocrinology due to the symptoms of active orbitopathy. The patient had significant proptosis (right eye-30mm, left eye29mm). Computed tomography showed thickening of oculomotor muscles in both eyes but also a mucous cyst localized in the right frontal sinus. The patient underwent endoscopic, intranasal removal of the lesion. Due to active, moderate to severe orbitopathy, he underwent treatment with 12 weekly pulses of intravenous methylprednisolone, followed by a 3-month prednisone therapy and orbital radiotherapy. The case describes the patient with two coexisting pathologies. Each of them could manifest itself with proptosis. The main cause of proptosis is GO. Physicians must bear in mind that in case of atypical course of GO and lack of improvement, or worsening during corticosteroid treatment, differential diagnosis should be considered. It is worth emphasizing that one of the reasons of proptosis may be a mucocoele (mucous retention cyst).
Citation
Katarzyna T, Beata R and Piotr M. Mucocoele and Graves’ Orbitopathy as the Causes of Proptosis in One Patient. SM J Endocrinol Metab. 2015;1(1):1005.