Abstract
A 34-year-old man presented with binocular proptosis for half a year and sight lost for seven days. The patient had a facial lymphoma resection and postoperative chemotherapy five years ago.
Citation
Wang D and Fang B. Biorbital Lymphoma with Severe Exophthalmos. SM Opthalmol J. 2015; 1(1): 1002
Clinical Image
A 34-year-old man presented with binocular proptosis for half a year and sight lost for seven days. The patient had a facial lymphoma resection and postoperative chemotherapy five years ago. Ocular examination revealed that both eyeballs were severely protruded, such that right and left eye protruded 38 and 33 mm respectively Figure 1 (Panel A).
Figure 1: Ocular examination.
Visual acuity test revealed that there was no light perception in either eye. MRI scans showed that there was a diffuse bilateral distribution of abnormal lesions in the orbit, orbital apex, and cavernous sinus area. The lesions extended to medial fossa along the dura mater. Musculature of the eyes and both optic nerves were surrounded by the lesions Figure 2 (Panel B).
Figure 2: Musculature of the eyes and both optic nerves were surrounded by the lesions.
Enhanced scanning of the lesions showed an abnormal homogeneous enhancement Figure 3 (Panel C).
Figure 3: Enhanced scanning of the lesions
Biopsy confirmed non-Hodgkin’s lymphoma, and based on the above findings, a diagnosis of biorbital lymphoma was made. The patient was given hormone therapy combined with systemic chemotherapy and after 15 days, the proptosis was significantly reduced and visual acuity restored to light perception. At a 3-month follow-up visit, the patient’s condition was stable.