Abstract ID: 26-616
Not Every Swollen Orbit Is Recurrence: Recurrent Orbital Inflammation Following Treated Sinonasal Lymphoma
Author: Li Teng Kok Base Hospital / Institution: Queen’s Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, London
Presentation Type: ePoster Presentation
Purpose
Periocular swelling in patients with previous sinonasal malignancy presents a significant oculoplastic diagnostic challenge. We present a case of recurrent orbital inflammation in a patient with treated sinonasal non-Hodgkin’s lymphoma (NHL), highlighting the importance of multidisciplinary (MDT) orbital assessment and long-term surveillance.
Methods
Case Report
Results
A 53-year-old male with a history of sinonasal NHL treated with chemoradiotherapy presented with recurrent episodes of periocular swelling several years after achieving remission.
CT imaging demonstrated bilateral frontal sinus opacification with focal left orbital extension and was concerning for orbital cellulitis versus lymphomatous recurrence. Intravenous antibiotics were commenced with rapid clinical improvement. Ocular assessment revealed mild residual periorbital swelling without proptosis, ophthalmoplegia or optic neuropathy.
Initial improvement was followed by recurrent bilateral upper eyelid and periorbital swelling over subsequent months. MDT review involving oculoplastics, ENT, radiology, and haematology considered both chronic inflammatory sinonasal disease and lymphoma recurrence within the differential diagnosis.
The patient subsequently underwent revision functional endoscopic sinus surgery with modified Lothrop procedure for persistent frontal sinus disease. Following surgery, orbital symptoms resolved completely with no further episodes of periocular swelling. Serial ophthalmic, endoscopic, and radiological follow-up demonstrated no evidence of recurrent lymphoma.
Conclusion
Orbital and periocular inflammation in prior sinonasal lymphoma represents a complex diagnostic entity. Post-treatment anatomical distortion, chronic sinus disease, and radiotherapy-related inflammatory changes may mimic recurrent malignancy both clinically and radiologically. This case demonstrates how orbital extension of frontal sinus inflammatory disease can masquerade as recurrent lymphoma and emphasises the importance of collaborative multidisciplinary management.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Elifhazal | Livanturkoglu | Queen’s Hospital |
| Anna | Gkountelia | Queen’s Hospital |