Immense Tumor of Maxillary Sinus with Exophthalmos-A Rare Underlying Cause

Sinus tumors are arduous to diagnose due to often prolonging asymptomatic course until the infiltration of the adjacent structures occurs. Therefore, patients are diagnosed with advanced-stage disease, which negatively affects the treatment outcomes. A 60-year-old male was referred to our ward from an outpatient clinic. The patient presented with double vision, right-side lacrimation, and exophthalmos. He also reported significant weight loss: 15 kg in 2 months. Physical examination revealed achiness and edema of the right temporal area, and subconjunctival hemorrhage of the right eye, and surprisingly no anosmia, no nasal obstruction, and no head/neck lymphadenopathy were present. The histopathology examination identified diffuse large B-cell lymphoma (CD20+ CD3- p63- bcl-2+ CD23-/+ bcl-6+ CD 10- MUM1+ Tdt- CD38- cyclin D1- CD30- c-myc+). The patient was qualified for R-CHOP immunochemotherapy (rituximab, cyclophosphamide, and hydroxydaunorubicin hydrochloride), which was well tolerated. After 3 months of treatment, all of the symptoms reversed and a whole-body PET scan showed no abnormal metabolic activity.