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February 1987

Radiation Therapy for Ocular Necrobiotic Xanthogranuloma

Author Affiliations

San Francisco

Arch Ophthalmol. 1987;105(2):174-175. doi:10.1001/archopht.1987.01060020028014

To the Editor.  —The diagnosis and management of orbital inflammations can be difficult. Necrobiotic xanthogranuloma can present with orbital and lid inflammatory signs.1,2 Patients usually have multisystem disease and the ocular prognosis has been guarded. We describe a patient who was treated with low doses of irradiation with excellent response.

Report of a Case.  —A 63-year-old woman had intermittent left ocular inflammation for five years. In February 1983, the sclera developed a yellowish discoloration in the region of the lacrimal gland. A computed tomographic scan and multiple biopsy specimens obtained in August 1983 were consistent with an orbital pseudotumor.We first examined the patient in September 1983; abnormalities were limited to the left eye and orbit. There was ptosis, proptosis, limitation of lateral gaze, lower lid induration, and a yellowish mass involving the palpebral portion of the lacrimal gland (Fig 1). A computed tomographic examination demonstrated diffuse orbital inflammation.