Bone destruction of orbital wall: does it always imply malignancy?

Abstract This study reviewed the clinical characteristics, treatments, and outcomes of six patients (seven eyes) with idiopathic orbital inflammatory pseudotumor with bone destruction. CT and/or MRI showed that the medial wall was the most common site of orbital wall destruction (four of the seven eyes). All patients underwent surgery and were treated with postoperative methylprednisolone. Prognosis was assumed poor as this condition features by a wide range of anatomical involvement. The study suggests that complete surgical resection may lead to a favorable prognosis, as half of the patients reported no recurrence and a total relief of symptoms. We proposed a new classification of bone destruction for this condition based on imaging studies, which is usually perceived as malignant lesions. Histopathological examination for the definitive diagnosis of this condition is crucial.