A Rare Case of Bilateral Proptosis

  • Joao Fernandes Serodio Medicine IV Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
  • Marta Jonet Medicine IV Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
  • Miguel Trindade Medicine IV Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
  • Inês Coutinho Ophthalmology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
  • Catarina Favas Medicine IV Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal

Keywords

Palpebral MALT B-cell lymphoma, hepatitis C infection

Abstract

A 65-year-old man presented with a 2-year history of severe bilateral proptosis, palpable lymphadenopathy and moderate hepatosplenomegaly. A blood test was positive for hepatitis C infection. CT showed palpebral infiltrative lesions with regional progression through the temporal and masticatory spaces to the pharynx and hypopharynx causing almost complete airway obstruction. A palpebral biopsy was consistent with low-grade Bcl-2+ extra-nodal MALT non-Hodgkin B-cell lymphoma. The patient received six cycles of rituximab-based chemotherapy with clinical remission at 9-month follow-up. Bilateral proptosis is a rare presentation of several diseases. When brain CT excludes cavernous sinus pathology, thyroid ophthalmopathy or haematological malignancy should be considered.

References

  • Walia SS, Stelton CR, Shantha JG, et al. Bilateral proptosis as initial manifestation of mantle cell lymphoma. Am J Med 2013;126:862–863.

  • Zucca E, Bertone F. The spectrum of MALT lymphoma at different sites: biological and therapeutic relevance. Blood 2016;127:2082–2092.

  • Tasleem S, Sood GK. Hepatitis C associated B-cell non-Hodgkin lymphoma: clinical features and the role of antiviral therapy. J Clin Transl Hepatol 2015;28:134–139.
  • Published: 2018-10-30

    Issue: Vol 5 No 11 (view)

    Section: Articles

    How to cite:
    Serodio, J., Jonet, M., Trindade, M., Coutinho, I., & Favas, C. (2018). A Rare Case of Bilateral Proptosis. European Journal of Case Reports in Internal Medicine, 5(11). https://doi.org/https://doi.org/10.12890/2018_000966