[Exophthalmos and blindness disclosing an ethmoidal-maxillary malignant non-Hodgkin's T-cell lymphoma. Apropos of a case]

J Fr Ophtalmol. 1999 May;22(5):566-70.
[Article in French]

Abstract

Background: We report a case of non-Hodgkin's malignant lymphoma of the cervicofacial region revealed by unilateral exophthalmos and blindness, an unusual mode of expression.

Case report: A 40-year-old man with a 4-month history of diabetes mellitus had suffered from exophthalmos and blindness of the right eye for 20 years. Physical examination showed a homolateral hemifacial tumefaction and ophthalmoplegia. The right ocular fundus showed papillar edema and non-proliferative diabetic retinopathy. The left eye was normal. The otolaryngology explorations revealed a voluminous tumor in the anterior nasal cavity and in the cavum. Two biopsies were performed. Histology reported non-Hodgkin's T-cell lymphoma. Orbitocerebral and cervicofacial computed tomography visualized the aggressive ethmoidomaxillary extension with intraorbital and intracranial involvement. Chemotherapy (CHOP) combined with radiotherapy led to tumor regression and involution of the exophthalmos. Diagnostic difficulties, management and prognosis are discussed.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adult
  • Antibiotics, Antineoplastic / administration & dosage
  • Antineoplastic Agents, Alkylating / administration & dosage
  • Antineoplastic Agents, Hormonal / administration & dosage
  • Antineoplastic Agents, Phytogenic / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Blindness / etiology*
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / therapeutic use
  • Diabetic Retinopathy / complications
  • Doxorubicin / administration & dosage
  • Doxorubicin / therapeutic use
  • Ethmoid Sinus / pathology*
  • Exophthalmos / etiology*
  • Humans
  • Lymphoma, T-Cell / complications*
  • Male
  • Maxillary Sinus Neoplasms / pathology*
  • Neoplasm Invasiveness
  • Nose Neoplasms / complications
  • Orbital Neoplasms / complications
  • Paranasal Sinus Neoplasms / complications*
  • Prednisone / administration & dosage
  • Prednisone / therapeutic use
  • Vincristine / administration & dosage
  • Vincristine / therapeutic use

Substances

  • Antibiotics, Antineoplastic
  • Antineoplastic Agents, Alkylating
  • Antineoplastic Agents, Hormonal
  • Antineoplastic Agents, Phytogenic
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone

Supplementary concepts

  • CHOP protocol