A Rare Case of Bilateral Proptosis

Authors

• Joao Fernandes Serodio Medicine IV Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
• Marta Jonet Medicine IV Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
• Miguel Trindade Medicine IV Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
• Inês Coutinho Ophthalmology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
• Catarina Favas Medicine IV Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal

jserodio@campus.ul.pt

Keywords

Abstract

A 65-year-old man presented with a 2-year history of severe bilateral proptosis, palpable lymphadenopathy and moderate hepatosplenomegaly. A blood test was positive for hepatitis C infection. CT showed palpebral infiltrative lesions with regional progression through the temporal and masticatory spaces to the pharynx and hypopharynx causing almost complete airway obstruction. A palpebral biopsy was consistent with low-grade Bcl-2+ extra-nodal MALT non-Hodgkin B-cell lymphoma. The patient received six cycles of rituximab-based chemotherapy with clinical remission at 9-month follow-up. Bilateral proptosis is a rare presentation of several diseases. When brain CT excludes cavernous sinus pathology, thyroid ophthalmopathy or haematological malignancy should be considered.