DOI: https://doi.org/10.36347/sasjs.2026.v12i07.012

Pages: 641-644

Background: Orbital tuberculosis is a rare form of extrapulmonary tuberculosis that may mimic orbital inflammatory diseases or malignant tumors, making diagnosis particularly challenging. Case presentation: A 55-year-old woman presented with a two-month history of painless right infraorbital swelling associated with unilateral proptosis. Orbital MRI demonstrated a lesion involving the inferior rectus tendon with adjacent soft tissue infiltration, initially suggestive of an orbital neoplasm. Histopathological examination of an incisional biopsy revealed caseating granulomatous inflammation consistent with tuberculosis. No evidence of pulmonary tuberculosis was found. The patient was treated with standard six-month antituberculous therapy, resulting in complete clinical recovery without recurrence. Conclusion: Orbital tuberculosis should be considered in the differential diagnosis of slowly progressive orbital masses, even in the absence of systemic symptoms or pulmonary involvement. Early biopsy and histopathological confirmation are essential for timely diagnosis and appropriate treatment.