Lymphoma of the orbit masquerading as Tolosa-Hunt syndrome

作者：Shazly Tarek A^*; Mitchell Ellen B; Bonhomme Gabrielle R; Schuman Joel S

来源：BMC Ophthalmology, 2015, 15(1): 51.

DOI：10.1186/s12886-015-0037-8

• Lymphoma
• Tolosa-Hunt
• Neuro-imaging
• Cavernous sinus
• MRI

Background: Tolosa-Hunt syndrome is a rare clinical syndrome characterized by painful ophthalmoplegia and ipsilateral cranial neuropathies. It is caused by an inflammatory process of unknown etiology.
Case presentation: We present a case of a 77-year-old white man with history of Waldenstrom's macroglobulinemia transforming to large B-cell lymphoma who presented to a community physician complaining of 4 months of isolated right retro-orbital pain and later with diplopia, ptosis, 6th nerve and pupil-sparing partial 3rd nerve palsies as well as progressive neurological findings. His clinical course was complicated by debilitating neurological symptoms and multiple hospitalizations leading to a delay in diagnosis caused by incomplete initial workup.
Conclusion: This case is a reminder that lymphoproliferative disorders often mimic other neurologic disorders and that Tolosa-Hunt is a rare diagnosis that must be considered a diagnosis of exclusion.

• 出版日期2015-5-15