This 54-year-old woman presents with periorbital swelling. What could be the underlying cause?
Analysis
Here, we see a case of orbital lymphoma. There are four common types: extra-nodal marginal zone B-cell (EMZL), diffuse large B-cell, follicular, and mantle cell lymphoma.
Most orbital lymphomas occur unilaterally in patients over age 50. The classic presentation is gradual, painless proptosis with a firm, palpable lesion in the anterior orbit. However, the signs and symptoms tend to be very subtle. Radiotherapy is the first-line treatment modality for orbital lymphoma and prognosis is generally favourable, particularly for conjunctival lymphoma without orbital involvement.
In this 9-minute video featuring Dr. Ahsen Hussain, assistant professor at Dalhousie University in Nova Scotia, you will:
- Learn the various presentations of orbital lymphoma
- Learn how to do a thorough work-up for orbital lymphoma
- Review the management for orbital lymphoma
Plastics Coach Tip
Always check the fornices for subtle signs of orbital lymphoma. Pull the lower lid away from the globe and evert the upper lid for thorough examination.
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