Primary Orbital Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type, without Nasal Involvement

Area of Science:

• Oncology
• Ophthalmology
• Pathology

Background:

• Extranodal natural killer/T-cell lymphoma, nasal type (ENKL) typically affects the nasal cavity or nasopharynx.
• While orbital involvement can occur, primary orbital ENKL without nasal symptoms is exceptionally rare.

Observation:

• A 61-year-old woman presented with a rapidly growing, painless salmon-colored mass in the right inner canthus.
• Clinical examination revealed limited medial eye motility and external deviation of the right eyeball.
• MRI confirmed an orbital mass without sinus involvement.

Findings:

• Histopathological examination diagnosed primary orbital extranodal natural killer/T-cell lymphoma, nasal type.
• The patient's orbital mass significantly regressed following chemotherapy.
• The patient remains alive with good quality of life and no systemic metastasis over one year post-diagnosis.

Implications:

• This case highlights that ENKL can manifest primarily in the orbit, even without initial nasal symptoms.
• Early detection through biopsy and timely, appropriate treatment are crucial for managing orbital ENKL.
• Successful treatment can lead to tumor control, prolonged survival, and preserved quality of life in patients with this rare presentation.