A 15-YEAR-OLD boy was referred to us with a 3-month history of progressive left frontal pain. His visual function was undisturbed.
The results of an eye examination were normal, except for a slight fullness of the superolateral orbital rim (Figure 1). Computed tomography revealed a 9x7-mm smooth, target-shaped lesion with a radiodense center, lucent rim, and surrounding sclerosis (Figure 2). A technetium Tc 99m medronate disodium scan demonstrated increased accumulation in the lesion (Figure 3). En bloc excision via an eyelid crease incision was performed. The poorly vascularized, crumbling lesion was well delineated from the normal bone. The defect was repaired with hydroxyapatite cement. Results of histopathologic analysis were consistent with osteoid osteoma (Figure 4). Three months later, the patient's pain had resolved.
Sires BS, Benda PM, Stanley RB, Rosen CE. Orbital Osteoid Osteoma. Arch Ophthalmol. 1999;117(3):414. doi:10.1001/archopht.117.3.414