• A 70-year-old woman with a long history of nasal and sinus polyps developed bilateral proptosis and left total external ophthalmoplegia. She was known to have hypercalcemia, which was later discovered to be caused by a parathyroid adenoma. X-ray studies, including computerized tomography, revealed increased radiodensity in the ethmoid sinuses (due to dystrophic calcification from the hypercalcemia), partial absence of the orbital walls from earlier surgical procedures, and bilateral rounded, retrobulbar tumors. At surgery, glistening, yellow, transparent, and encapsulatedlobulated masses were removed from the left orbit; they appeared to have prolapsed through a postsurgical dehiscence in the superomedial orbital wall. Light and electron microscopy confirmed that the lesional tissue represented polyps covered by respiratory epithelium; the yellow color was the consequence of secondary lipidization of the stromal fibroblasts.
Jakobiec FA, Trokel S, Iwamoto T. Sino-orbital Polyposis. Arch Ophthalmol. 1979;97(12):2353–2357. doi:10.1001/archopht.1979.01020020569015
* * SCHEDULED MAINTENANCE * *
The JAMA Network Sites will be conducting routine maintenance from 10/20/2017 through 10/21/2017. During this window access to content and authentication may be intermittently available. The JAMA Store will be completely unavailable during the maintenance window.