Purpose: To present the clinical course of a patient with recurrent NK/T-cell lymphoma (NKTL) involving the orbit and to review the literature on patients with NKTL involving the orbit. Methods: The PubMed database was searched for all cases of NKTL involving orbital, intraocular, or adnexal ocular structures. Results: Ninety-six patients were included in the final analysis. The mean age of diagnosis was 48.1 ± 16.8 years. The patients were 53/96 (55.2%) male and 43/96 (44.8%) female. Tumor location varied and included the orbit in 80/96 (83.3%), nasosinus in 56/96 (58.3%), uvea in 11/96 (11.5%), lacrimal gland in 9/96 (9.4%), lacrimal drainage system in 11/96 (11.5%), and conjunctiva in 7/96 (7.3%) cases. Management included surgical debulking in 29/96 (30.2%) cases, radiotherapy in 52/96 (54.2%) cases, and chemotherapy in 82/96 (85.4%) cases. Median survival was 6 months (95% CI: 5–9). Chemotherapy (hazard ratio = 0.80, 95% CI: 0.67–0.95, p = 0.013), radiotherapy (hazard ratio = 0.75, 95% CI: 0.64–0.87, p < 0.001), and orbital involvement being a recurrence of disease (hazard ratio = 0.79, 95% CI: 0.67–0.95, p = 0.009) were associated with improved survival. Advanced Ann Arbor stage (III–IV) at diagnosis (hazard ratio = 1.22, 95% CI: 1.08–1.38, p = 0.001), vision loss (hazard ratio = 1.18, 95% CI: 1.04–1.34, p = 0.009), proptosis (hazard ratio = 1.15, 95% CI: 1.01–1.30, p = 0.035) and periorbital swelling (hazard ratio = 1.15, 95% CI: 1.00–1.33, p = 0.048) were associated with poor survival. Conclusions: NK/T-cell lymphoma involving the orbit, globe, or ocular adnexa heralds a poor prognosis where early diagnosis and therapy are critical. The use of radiotherapy and chemotherapy is associated with improved survival.

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FIG. 3. Immunohistochemical staining of the B-CLL cells demonstrated positive staining with CD5 (A) and CD20 (B), and negative staining with CD3 (C) (original magnification, 100×).

Introduction: We report an unusual case of demodex folliculitis presenting as isolated bilateral periorbital inflammation without other classical symptoms of demodicosis. Case Report: A 46-year-old female presented with bilateral eyelid edema without erythema for two years. She denied pain, itching, or rashes. Her ocular exam was unrevealing and without evidence of blepharitis or meibomian gland dysfunction. Inflammatory workup, including thyroid antibodies, was negative. Computed tomography (CT) orbits showed no orbital masses. She was trialed on oral doxycycline therapy with no improvement. Subsequent skin tissue biopsy from upper lid blepharoplasty was consistent with Demodex folliculitis, and the patient’s symptoms significantly improved after initiation of terpinen-4-ol (T40) tea tree oil eyelid wipes. Conclusion: This case suggests that Demodex folliculitis should be included in the differential diagnosis for bilateral periorbital inflammation, even in the absence of the typical signs and symptoms of ocular demodicosis.