Systemic Mantle Cell Lymphoma with Initial Presentation of Bilateral Ptosis-A Casr Report

Purpose: To report a rare case of systemic Mantle cell lymphoma with initial presentation of bilateral ptosis.Method: Interventional case report.Results: A 56-year-old female visited our hospital due to progressive left lid ptosis in the past three months. She had previously received four lid blepharoplasties. Soft palpable masses were noted over bilateral upper lids during examination. The margin reflex distance (MRD) of the right eye and the left eye was 2.5 mm and 0.5 mm, respectively. Orbital CT scan revealed crescent-shaped tissue swelling of bilateral upper lids. Excision of left eyelid tumor was performed, and the pathology revealed Mantle cell lymphoma of blastic variant type. Systemic survey showed bone marrow, mediastinum, and upper abdomen involvement. Further systemic chemotherapy was suggested immediately, but the patient refused any treatment at that time. After loss of follow-up for 2 years, she visited our clinic for surgical correction of her progressive right lid ptosis. After operation, she underwent palliative chemotherapy. However, the patient died 2 years later.Conclusion: There is a high proportion of systemic involvement in Mantle cell lymphoma of the eyelid. Our patient presented with systemic disease and rapidly progressive ptosis. Despite of delayed chemotherapy, the survival in our case is comparable with those of other reports.