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March 1994

Orbital Myositis as a Paraneoplastic Syndrome

Author Affiliations

From the Section of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology (Drs Harris and Murphy), the Division of Cancer and Blood Diseases, Department of Medicine (Dr Schmidt), the Section of Hematology, Department of Pathology (Dr Hanson), and the Neuromuscular Section, Department of Neurology (Dr Dotson), Medical College of Wisconsin, Milwaukee.

Arch Ophthalmol. 1994;112(3):380-386. doi:10.1001/archopht.1994.01090150110032

We describe a patient with bilateral orbital myositis, multiple cranial neuropathies, a sensory polyneuropathy, serum and cerebrospinal fluid paraproteins, and high-grade non-Hodgkin's lymphoma. Neurologic symptoms began more than 1 year before diagnosis of the lymphoma. Results of extraocular muscle biopsy showed extensive destruction of myofibers and granulomatous features, with no evidence of direct tumor involvement. The cranial neuropathies and orbital myositis improved with immunosuppressive therapy, while the patient's tumor progressed. We believe the orbital myositis and the multiple neurologic abnormalities were paraneoplastic effects of the lymphoma. To our knowledge, this is the first case of orbital myositis identified as a paraneoplastic syndrome.

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