PMC9911136_01
a: right orbital area swelling and ptosis of the right upper eyelid. b: clinical regression of the right orbital sweling and improvement of ptosis post three cycles of rituximab therapy.
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FIG1
Left eye examination was unremarkable (Figure 1a).
MRI of the orbit: a: (October 2019) significant proptosis of the right eye globe (red arrow) and swelling and enhancement of the extra-conal soft tissues (orange arrows), b: (December 2020) resolution of the proptosis and extra-conal findings post three cycles of rituximab therapy, c: (December 2021) sustained radiologic remission of the idiopathic orbital inflammation one-year post rituximab therapy.
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FIG2
MRI of the orbit conducted in October 2019 revealed proptotic right eye globe with extra-conal enhancing soft tissue that is possibly involving the lacrimal gland (Figure 2a).
Right orbital mass histopathology: dense fibrous connective tissue and striated muscles (green arrows) and chronic inflammatory cell infiltrates (yellow arrows).
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FIG3
For further assessment, biopsy of the right orbit was performed and showed fibrosis with CD20-positive inflammatory infiltrates, vascularized dense connective tissues and striated muscles (Figure 3).