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April 1, 2019

Image challenge: Hepatitis C and cannot see!

What caused eye pain, double vision, rapidly progressive loss of visual acuity and exophthalmos with ophthalmoplegia in a 56-year-old patient?

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Gastroenterology clinical image challenge: A 56-year-old Native American man with a history of hepatitis C infection presented with worsening eye pain, double vision, rapidly progressive loss of visual acuity and exophthalmos with ophthalmoplegia in his right eye. Physical examination findings were suggestive of liver cirrhosis. Cross-sectional imaging of the head and neck showed large extra-axial mass lesion involving the sphenoid wing of the right orbit, anterior cranial fossa, middle cranial fossa, sinus and temporal fossa (Figure). Thyroid function tests were within normal limits.

 

What is the diagnosis?

 

To find out the diagnosis, read the full case in Gastroenterology or download our Clinical Image Challenge app through AGA App Central, which features new cases each week. Sort and filter by organ, most popular or favorites. AGA App Central is available in both the Apple App Store and Google Play.

 

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