gms | German Medical Science

In this case report, we present two patients with bilateral orbital tumors. In both cases, patients presented to the clinic after one year of persistent ophthalmological symptoms, one of the patients with gradual vision loss and the other one with progressive exophthalmus. Both patients had infraorbital tumor detected by CT scan/MRI. Preoperatively, both patients considered to have lymphomatous disease. Tumor biopsy was obtained using endoscopic endonasal technique and sent for histological analysis.

The patient with vision loss had a chronic benign lymphomatoid hyperplasia located in the inferior wall of the orbit, infiltrating infraorbital nerves on both sides. The tumor and the patient’s symptoms could only be controlled by giving repeated boluses of corticosteroid injections as well as a prolonged course of low dose corticosteroid. The other patient with bilateral exophthalmus had a xanthoma in the region of the apex of the orbit. Xanthomas are often associated with lymphoproliferative disorders, which is not true in this case.

Orbital tumors are of rare incidence and often turn out to be lymphomas, meningiomas and hemangiomas, with sporadic bilateral presentation. Chronic benign lymphomatoid hyperplasia and xanthomas are extremely rare, a specific therapy is unknown.