Orbital Pseudotumor

Findings:

Marked asymmetric enlargement of the right medial rectus muscle is present, which demonstrates decreased T2 signal, intermediate T1 signal, and diffuse enhancement. The enlargement and abnormal enhancement of the medial rectus muscle extends to the tendinous attachment anteriorly.

Discussion:

Pseudotumor favored due to isolated EOM involvement, involvement of the tendinous attachment, and T2 hypointensity. Lymphoma can appear similar, thyroid orbitopathy less likely due to the isolated unilateral medial rectus involvement.

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