소아 안와가성종양의 임상적 양상 및 치료에 대한 고찰
Clinical Characteristics of Pediatric Orbital Pseudotumors
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목적: 소아 안와가성종양 환자를 대상으로 임상증상, 영상 의학적 소견, 치료에 대해 알아보고자 한다. 대상과 방법: 2008년 8월부터 2012년 2월까지 본원을 방문하였던 20세 이하 안와가성종양환자를 대상으로 후향적 의무기록 조사를하였다. 결과: 총 13명, 16안이 대상이 되었으며, 평균 나이는 14.2세(5-20세)였다. 임상양상은 안검부종(56.3%), 안검하수(43.8%), 결막충혈(18.8%), 국소종괴(18.8%), 안구운동장애(12.5%), 안구돌출(6.3%), 시력저하(6.3%) 순으로 관찰되었고 전산화단층촬영에서는 눈물샘염(62.5%), 외안근염(18.8%), 앞안와염(18.8%), 미만성(6.3%) 순으로 관찰되었다. 10안(8명)에서 경구 전신적 스테로이드 치료, 2안(2명)에서 경정맥 전신적 스테로이드 치료, 1안(1명)에서 전신적 스테로이드 및 NSAID, 나머지 3안(2명)에서 NSAID 치료가 시행되었다. 치료 시작 후 평균 4.1일 후부터 증상이 호전되었고, 미만성 소견을 보였던 1안에서 2차례 재발을 보였다. 결론: 안와가성종양은 소아에서 드물게 발생하는 질환으로 스테로이드에 치료효과가 빠르게 나타나며 재발은 드물었다.
Abstract
Purpose: To describe the clinical manifestations, radiologic findings, and treatment outcomes of pediatric pseudotumors. Methods: A retrospective chart review of patients diagnosed with pediatric pseudotumor (age under 20 years old) from August 2008 to February 2012 was performed. Results: Thirteen patients (16 eyes) were included in this study. The mean age of the subjects was 14.2 years (5-20 years). Swollen eyelid (56.3%), ptosis (43.8%), conjunctival injection (18.8%), localized mass (18.8%), limitation of ocular movement (12.5%), proptosis (6.3%), and decreased visual acuity (6.3%) were found initially. Dacryoadenitis (62.5%), myositis (18.8%), anterior orbital inflammation (18.8%), and diffuse type (6.3%) were observed on orbital computed tomography (CT). Among the 13 patients (16 eyes), 8 patients (10 eyes) were administered oral systemic corticosteroids, 2 patients (2eyes) received IV systemic corticosteroid, 1 patient (1 eye) received systemic corticosteroids combined with NSAID, and 2patients (3 eyes) were prescribed NSAIDs only. Symptoms improved 4.1 days after initiation of treatment. CT scans revealed that one patient experienced diffuse-type disease recurrence twice. Conclusions: Orbital pseudotumors, which are rare in younger people, are likely to respond very well to corticosteroid treatment, and the recurrence of orbital inflammation is rare.
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