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Peer-reviewedCC BY 4.0American Journal of Ophthalmology Case Reports

Radiopaque orbital foreign bodies from retained infant brachytherapy seeds

  • Megan Jung1
  • Kapil Mishra1,2
  • Lilangi S. Ediriwickrema1,2
  1. 1University of California, Irvine, School of Medicine, Irvine, CA, 92697, USA
  2. 2Gavin Herbert Eye Institute, Department of Ophthalmology, University of California, Irvine, 92697, USA
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Abstract

Purpose: The purpose of this case report is to describe a rare case of retained orbital brachytherapy seeds implanted during infancy and identified in an older adult undergoing neurocognitive evaluation. It highlights a multidisciplinary approach to diagnosis and management.

Observations: An 85-year-old man presented for removal of radiopaque periocular foreign bodies prior to magnetic resonance imaging (MRI) for a neurocognitive workup. The patient reported undergoing “seed placement” radiation therapy to the right orbital region at 18 months of age in Scotland for a superior right orbital mass, suspected to be a capillary hemangioma. Computed tomography revealed two discrete radiopaque foreign bodies in the superior right orbit and right medial nasal soft tissue. Multidisciplinary evaluation with ocular oncology and radiation safety suggested that the foreign bodies were retained casings from historical radon-222 brachytherapy seeds. Preoperative and intraoperative assessments demonstrated no detectable residual radioactivity, and the foreign bodies were removed successfully, allowing the patient to proceed with MRI.

Conclusions and importance: This case highlights the importance of recognizing historical radiation treatments as potential causes of orbital foreign bodies and imaging artifacts in older adult patients. It also underscores the value of multidisciplinary management for the safety of patients.

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Cite

BibTeXRIS
BibTeX
@article{jung2026radiopaque,
  title = {{Radiopaque orbital foreign bodies from retained infant brachytherapy seeds}},
  author = {Megan Jung and Kapil Mishra and Lilangi S. Ediriwickrema},
  journal = {American Journal of Ophthalmology Case Reports},
  year = {2026},
  month = oct,
  doi = {10.1016/j.ajoc.2026.102693},
  url = {https://doi.org/10.1016/j.ajoc.2026.102693},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Radiopaque orbital foreign bodies from retained infant brachytherapy seeds
AU  - Megan Jung
AU  - Kapil Mishra
AU  - Lilangi S. Ediriwickrema
PY  - 2026
DA  - 2026/10/23
JO  - American Journal of Ophthalmology Case Reports
DO  - 10.1016/j.ajoc.2026.102693
UR  - https://doi.org/10.1016/j.ajoc.2026.102693
AB  - Purpose: The purpose of this case report is to describe a rare case of retained orbital brachytherapy seeds implanted during infancy and identified in an older adult undergoing neurocognitive evaluation. It highlights a multidisciplinary approach to diagnosis and management.  Observations: An 85-year-old man presented for removal of radiopaque periocular foreign bodies prior to magnetic resonance imaging (MRI) for a neurocognitive workup. The patient reported undergoing “seed placement” radiation therapy to the right orbital region at 18 months of age in Scotland for a superior right orbital mass, suspected to be a capillary hemangioma. Computed tomography revealed two discrete radiopaque foreign bodies in the superior right orbit and right medial nasal soft tissue. Multidisciplinary evaluation with ocular oncology and radiation safety suggested that the foreign bodies were retained casings from historical radon-222 brachytherapy seeds. Preoperative and intraoperative assessments demonstrated no detectable residual radioactivity, and the foreign bodies were removed successfully, allowing the patient to proceed with MRI.  Conclusions and importance: This case highlights the importance of recognizing historical radiation treatments as potential causes of orbital foreign bodies and imaging artifacts in older adult patients. It also underscores the value of multidisciplinary management for the safety of patients.
SN  - 2451-9936
ER  -