A 7-year-old boy who had
learning difficulty was referred to our department from another eye unit because
of a one-week history of progressive left proptosis. He was initially managed as
orbital cellulitis because of a recent history of dental cary. CT scan showed a
lateral orbital mass with extension into the temporal fossa and the cranium. The
maxillary sinus was opaque.
Figure 1. One-week history of progressive left proptosis with cheek
and temporal fossa swellings.
Figure 2. CT scans of the maxillary sinus and orbit showing opacity in the left
maxillary sinus (above) and lateral orbit, cranium and the temporal fossa.
a. Why is orbital cellulitis an unlikely diagnosis in this patient?
b. What is the most likely diagnosis?
c. How would you manage this patient ?