Bilateral levator palpebrae superioris involvement by malt lymphoma

Aims: Lymphoma is the most common malignant tumour in the ocular region. Among its histopathological subtypes, mucosa‐associated lymphoid tissue (MALT) is the most frequent. Extraocular muscles’ affectation by MALT lymphoma of the eye is uncommon (5%), more if possible, infiltration of levator palpebrae superioris (EPS), have not been described affectation of EPS isolated and none bilateral so far: We report one case of bilateral EPS involvement by MALT lymphoma. Methods: A 67‐year‐old lady noticed of gradually solitary mass increment on the right upper eyelid. Examination revealed a fibrous, nonpitting, hard and non‐tender, subciliary mass measuring 2‐3 cm on this eyelid. The rest of the ophthalmological examination was normal. Orbital magnetic resonance imaging showed infiltration of right EPS. The histological and immunohistochemical result of the biopsy was MALT lymphoma. The serology resulted negative for Chlamydophila psittaci. Three weeks later a similar mass appears in the left upper eyelid. Results: Ann Arbor's stage IV‐A was established. Haematology Committee decided treatment with six cycles of immunochemotherapy with: R‐CVP (Rituximab‐Cyclophosphamide‐Vincristine‐Prednisone). The tumor disappearance after the 4th cycle. Conclusions: MALT lymphoma is the most frequent ocular adnexal lymphoma, although extraocular muscles involvement is rarity entity itself. The most common affected muscle is superior rectus. Eligible treatment for limited type is locoregional radiotherapy. In case of advanced disease chemotherapy is preferred. Hence MALT lymphoma is a rare disease, which frequently recurs locally and has potential for systematic spread and transformation to a high‐grade B cell lymphoma, so warrant alertness to this neoplasm is required to reach an early diagnosis. References Abalo‐Lojo, J. M., Baleato‐Gonzalez, S., Abdulkader, I., & Gonzalez, F. (2011). Extraocular muscle involvement in MALT lymphomas. Orbit (Amsterdam, Netherlands), 30(4), 186–188.