A 16-year-old boy from Nilphamari, Bangladesh
presented with the complaints of gradual swelling of
the left eye with protrusion over 1 year, increased thirst
with polyuria for 2 months, and weight loss of around 5
kg over the same duration. The eye swelling was
insidious in onset, limited to the left eye, associated with
some redness but no lacrimation or fever and headache.
He complained of excessive thirst, having to take up to
16 litres of water per day, which was associated with
polyuria, including nocturia. He also developed two
bony swellings on the left side of his skull which was
associated with mild tenderness on palpation.