Orbital myositis as a paraneoplastic syndrome
G. J. Harris, M. L. Murphy, E. W. Schmidt, G. A. Hanson and R. M. Dotson
Department of Ophthalmology, Medical College of Wisconsin, Milwaukee.
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.
