title: Bilateral orbital tumor formation and isolated facial palsy in Waldenstrom's macroglobulinemia.
abstract: A 32-year-old lady presented with bilateral painful proptosis and left infranuclear facial palsy. She was mildly anemic. Ocular examination revealed a firm non-tender mass in the super lateral quadrant of both orbits. Fine-needle aspiration cytology from the orbital mass showed the presence of lymphoplasmacytoid cells. Bone marrow aspiration also showed the presence of similar cells. An IgM monoclonal gammopathy was seen on serum protein electrophoresis. A diagnosis of Waldenstrom's macroglobulinemia was made on the basis of these findings. Hyperviscosity retinopathy is the most commonly reported ocular abnormality in Waldenstrom's macroglobulinemia. Orbital tumor formation and cranial nerve palsies are rarely reported in this condition. We describe the first case of Waldenstrom's macroglobulinemia presenting as an isolated orbital mass and facial nerve palsy.
authors.affiliation: Guru Nanak Eye Centre, New Delhi, India.
authors.forename: Sushil
authors.initials: S
authors.lastname: Kumar
authors.forename: Sima
authors.initials: S
authors.lastname: Das
authors.forename: J L
authors.initials: JL
authors.lastname: Goyal
authors.forename: D
authors.initials: D
authors.lastname: Chauhan
authors.forename: V
authors.initials: V
authors.lastname: Sangit
mesh_terms: D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D044963:Biopsy, Fine-Needle; D002699:Chlorambucil / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005158:Facial Paralysis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D009918:Orbital Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use; D008258:Waldenstrom Macroglobulinemia / Q000150:complications* / Q000188:drug therapy / Q000473:pathology
chemical_list: D018906:Antineoplastic Agents, Alkylating; D005938:Glucocorticoids; D002699:Chlorambucil; D011239:Prednisolone