64 year old female with new onset of left proptosis. Thyroid eye disease versus mass. The extraocular musculature remain within normal size and configuration. The retro-orbital fat remains within normal limits. There is a slight prominence of the right optic nerve at the site of its insertion to the right globe. No definitive evidence of enhancement in this region is detected. Review of prior MRI examination of brain without infusion from 2007 demonstrated similar finding with no interval change. The osseous structures of the orbits are unremarkable. There is prominence of bilateral superior ophthalmic veins. MRI examination of this patient from 8 -- 30 -- 2007 was reviewed which also demonstrated prominence of superior ophthalmic veins however no abnormality at the level of cavernous sinus was noted on that exam.The paranasal sinuses are well pneumatized are unremarkable with the exception of a small retention cyst in the dependent portion of right maxillary sinus. No abnormality at the level of the skull base is detected.
1.No evidence of Graves' ophthalmopathy or mass in the orbit as clinically is questioned.2.Prominence of bilateral superior ophthalmic veins which has remained stable since prior MRI examination of brain without and fusion from 8 -- 30 -- 2007.3.Prominence of right optic nerve immediately posterior to the globe no enhancement as detailed.4.Dedicated MRI examination of orbits and region of the sella with infusion is recommended for further evaluation of the above findings.