Not all masses are tumours!

This was a 13 year old teen who presented with a mass under her left eye pushing the eyeball up. 

Patient at presentation

The CT scan showed a multi-cystic mass encasing the lower part of the globe. Three cysts were dicernated in the scan.

CT Scan showing the mass encasing the eyeball 

She was taken up for surgery. Exploratory Orbitotomy with excision biopsy of the mass in toto was done. It turned out to be an interesting case. It was a multi-cystic mass as observed in the CT scan. The anterior-most cyst was infected and purulent discharge oozed out of a small defect in the cyst. The purulent discharge was due to a super added infection by Klebsiella bacterium.

The histopathology of the mass turned out to be characteristic of tissue infected with Mycobacterium Tuberculosis. In the sub-continent, tuberculosis (TB) is always a differential even when tests for TB turn out to be negative. Histopathology is gold standard for diagnosing TB.  Orbital TB though not always a top clinical diagnosis it is not uncommon.

Since the complete mass was excised completely without any residual lesion left behind, decision was made to not treat the patient further with any anti-TB medications and to observe with close follow up.

There has been no recurrence 1 year since surgery. 

Before and After surgery
Note that there is no visible scar of the incision where the mass was removed from in the after surgery picture. 

Exploratory Orbitotomy with Excision Biopsy of mass:
⏲Surgery time: 45-60 mins depending on the size of the eyelid mass. 
💉Anaesthesia: Done under General anaesthesia
🗓️Downtime: 2 weeks
📈Duration of effect: Permanent.
📠 Phone: +91 80 2502 3257
🖥️ Website:

Published by Dr. Raghuraj Hegde

Free thinker| Poet| Writer| Traveller| Doctor| Ophthalmic Plastic Surgeon

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