RESUMEN
Aim: To present the case of a 57-year-old male with progressive bilateral proptosis. Material and method: The patient presented with bilateral proptosis and strength deficiency on the upper limbs. During hospitalization, the progression was unfavorable; proptosis progressed, causing a severe loss of vision in the left eye (from 0.8 Snellen to NLP). Results: The imagistic investigation revealed bilateral infiltration of the orbits, infiltrative lesions to the mediastinum and the abdomen. The patient was referred to neurosurgery for further management. Surgical orbital decompression was performed with biopsy. The histopathological examination revealed non-Hodgkin small cell lymphoma. Conclusions: Assembling the clinical and paraclinical data we have suspected the possible diagnosis of Erdheim-Chester disease, however, positive diagnosis has not been achieved.
Asunto(s)
Enfermedad de Erdheim-Chester/diagnóstico , Exoftalmia/diagnóstico , Linfoma no Hodgkin/diagnóstico , Trastornos de la Visión/diagnóstico , Biopsia , Descompresión Quirúrgica , Diagnóstico Diferencial , Electromiografía , Enfermedad de Erdheim-Chester/cirugía , Exoftalmia/cirugía , Humanos , Linfoma no Hodgkin/cirugía , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Trastornos de la Visión/cirugía , Agudeza Visual/fisiologíaRESUMEN
We present the case of a schizophrenic patient in acute psychosis, with religious delusions, and autoaggressive acts, resulting amaurosis of the right eye and impairment of the other, and showing the difficulties of managing and therapy, as the crucial importance of the team work between the ophthalmologist, the neurologist and the psychiatrist.