SYSTEMIC SARCOIDOSIS INITIALLY PRESENTING AS AN ORBITAL TUMOR

A 73 year old woman presented with redness, itching and painless propt osis of the left eye. Clinical examination and computed tomographic (C T) scan of the orbit revealed a postero-ocular mass, the biopsy of whi ch showed a noncaseating, giant cellular, epithelioid granuloma compat ible with sarcoidosis, The patient had no respiratory complaints, but the thoracic CT scan showed multiple bilateral hilar and mediastinal a denopathies. Gallium scan showed increased uptake in both hilar region s, in the left orbit and in the right parotid gland, Multiple bronchia l biopsies revealed sarcoid granulomas, with a bronchoalveolar lavage (BAL) cytological pattern of active sarcoidosis, The evolution was fav ourable with prednisolone given at a dose of 0.5 mg . kg(-1) daily. It is suggested that in an unusual presentation of sarcoidosis, a thorou gh search should be made for localization at other sites, lungs in par ticular, even in the absence of respiratory complaints.