Endoscopic removal of an intraorbital "tumor": A vital surprise

We present the first case report of an endoscopic removal of a living worm, species Dirofilaria repens, from the orbital cavity. As of today, over 410 cases of Dirofilaria repens infections in man are recorded in world litera ture, six of which were localized in the orbital cavity. In Austria we know of four cases of an infection with this parasite, brit none in the orbit. Dirofilaria repens is widespread only in the Old World, particularly in Sou thern and Eastern Europe, in Asia Minor, and in Central and Southern Asia. The highest prevalence of the disease is recorded in Italy (181 cases). In clinical practice, the infections have mostly been misdiagnosed as a neopla sia, usually benign bur sometimes malignant. Under the assumption of an int raorbital tumor, the endoscopic transnasal revision of the orbital cavity w as performed, as this approach promised to be least traumatic and best suit ed for the lesion, resulting in complete removal of the live worm. In uncle ar lesions in the head and neck, nit infection with Dirofilaria repens shou ld be considered as a differential diagnosis.