Orbital Apex Malignant Lymphoma Diagnosed Using Whole-Body Computed Tomography

Area of Science:

• Oncology
• Ophthalmology
• Radiology

Background:

• Orbital apex masses can present diagnostic challenges, potentially mimicking other conditions.
• Early and accurate diagnosis is crucial for managing malignant lymphomas and preventing vision loss.

Observation:

• A 69-year-old female with rheumatoid arthritis and hypertension developed left eye ptosis and headache.
• Orbital MRI revealed a mass at the orbital apex; whole-body CT identified disseminated disease including liver, pancreas, and cardiac lesions.
• Biopsies confirmed diffuse large B-cell lymphoma (DLBCL).

Findings:

• Whole-body CT imaging is essential for identifying primary or metastatic sites for biopsy in suspected orbital apex lymphoma.
• Despite prompt chemotherapy, optic nerve damage led to irreversible visual impairment.

Implications:

• This case underscores the importance of comprehensive diagnostic workups, including advanced imaging like whole-body CT, for orbital apex lesions.
• Timely initiation of treatment for malignant lymphoma is critical to prevent severe complications such as permanent vision loss.