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Orbit/Oculoplastics Quiz 21: A 16 Year Old Boy With Periorbital Headaches
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Ben Kim | Massachusetts Eye and Ear Infirmary
Sureka Thiagalingam | Massachusetts Eye and Ear Infirmary
Calliope Allen | Massachusetts Eye and Ear Infirmary

November 12, 2006
[View Answers] [Back to Orbit/Oculoplastics]
Figure 1
Clinical appearance at presentation. There is mild edema of the right upper eyelid.
Figure 2
CT scan at the time of presentation. There is a predominantly lytic lesion of the right frontal bone.

Case History
An otherwise healthy 16 year old boy presented with a history of 2 months of mild right upper lid edema and periorbital headaches. Although there was no complaint of diplopia, the patient was found to have a slight limitation of upgaze for the right eye.
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Questions
1. What is the differential diagnosis for a destructive bone lesion of the superotemporal orbit in a pediatric patient?
2. How would you diagnose this patient?
3. How should a systemic workup be performed?
4. How should one follow the patient?
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[View Answers]