%0 Journal Article
%T Local recurrence as extraocular muscle lymphoma after 6 years of chronic myositis: a case report.
%A Guo Q
%A Liu R
%A Zhang X
%A Yang B
%A Ma J
%J BMC Ophthalmol
%V 22
%N 1
%D Oct 2022 8
%M 36209053
%F 2.086
%R 10.1186/s12886-022-02623-4
%X <B>BACKGROUND: </B>Extraocular muscle is usually affected by thyroid disease or inflammatory pseudotumor, but seldom by neoplastic process. Primary malignant lymphoma involving isolated extraocular muscle is very rare, especially after 6 years of chronic myositis.<BR><B>METHODS: </B>A middle-aged female presented with swelling of the lower lid of the right eye for 2 months. Magnetic resonance imaging showed significant enlargement of the right inferior rectus muscle belly. The patient first presented 6 years prior with upper eyelid swelling. A total of 5 surgical biopsies of the right eye were performed during 6 years with the following successive findings: inflammatory pseudotumor, chronic inflammation, inflammatory lesions, IgG4-related ophthalmic disease, and lastly, extraocular muscle extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma).<BR><B>CONCLUSIONS: </B>MALT lymphoma may have occurred as a result of chronic extraocular myositis. Malignancy should be considered in patients with recurrent painless extraocular muscle hypertrophy. Differential diagnosis can rule out thyroid-associated ophthalmopathy (TAO), whose symptoms are similar. Diagnosis confirmation by biopsy is warranted if necessary.