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JAMA Clinical Challenge
Clinician's Corner
February 13, 2013

Unilateral Proptosis

Author Affiliations

JAMA Clinical Challenge Section Editor: Huan J. Chang, MD, Contributing Editor. We encourage authors to submit papers for consideration as a JAMA Clinical Challenge. Please contact Dr Chang at tina.chang@jamanetwork.org

Author Affiliations: Investigational Cancer Therapeutics (Phase I Clinical Trials Program), MD Anderson Cancer Center, Houston, Texas.

JAMA. 2013;309(6):605-606. doi:10.1001/jama.2013.233

A 40-year-old man presents with left periorbital swelling and pain,which developed gradually over 2 months with no history of trauma, fever, or recent sinusitis. He has no previous medical illness and is not taking any medications. The patient denies diplopia and exposure to allergic or contact irritants. Physical examination confirms chemosis and left proptosis (Figure 1) without pulsation or bruit. The patient is neurologically intact, including normal pupillary response and extraocular movements. Laboratory studies are unremarkable, including normal complete blood cell count findings, negative blood cultures, and normal thyroid-stimulating hormone values.