Two Cases of Primary Orbital Lymphoma

Abstract

We report the successful treatment of two patients with primary orbital non-Hodgkin's lymphoma by radiotherapy followed by surgical resection. The chief complaint of both patients was orbital swelling. One patient, a 66-year-old female, had stage IA disease (Ann Arbor staging system), and the other was an 85-year-old female with stage IVA disease. The pathological diagnosis of the stage IA patient was follicular lymphoma (new WHO classification: mainly diffuse, grade 3) and that of the stage IVA patient was diffuse large B-cell lymphoma (new WHO classification). Lymphoma cells in both patients showed a B-cell phenotype. We recommended chemo-radiotherapy treatment to the stage IVA patient, but she and her family rejected this opinion because of her advanced age. We obtained good results by administering a total dose of 34Gy in 17 daily fractions to each patient, with lead eye shield protection. We consider that the patients received identical total doses of radiotherapy. We were concerned that cataracts or other radiation side effects would occur, but none has appeared during 1 year of follow-up care. Carefully planned radiotherapy accompanied by ocular shielding appears to be safe and effective for orbital lymphoma.