Horner's Syndrome: an unusual ophthalmological presentation of Hodgkin lymphoma

Abstract

c. abascal azanza, R. abárzuza cortaire, P. Plaza Ramos REsUMEn El Síndrome de Horner (SH) es un síndrome neuroló-gico que se caracteriza por la triada miosis pupilar incompleta, ptosis palpebral y anhidrosis facial debido a la lesión de la vía oculosimpática, compuesta por tres neuronas, desde el hipotálamo hasta el ojo. Identificar su causa representa un reto diagnóstico ya que, a pesar de su aparente levedad clínica, el SH puede ser la primera o única manifestación de un trastorno grave o incluso potencialmente mortal. Presentamos el caso de un paciente varón de 19 años con una historia de molestias oculares inespecíficas de dos meses de evolución. Acudió a la consulta de urgencias de Oftalmología en la que fue diagnosticado de un SH como primera manifestación clínica de linfoma de Hodgkin. aBstRactHorner's Syndrome (HS) is a neurological syndrome characterised by the triad incomplete pupillary miosis, palpebral ptosis and facial anhidrosis, due to a lesion of the oculosympathetic pathway, formed of three neurons from the hipothalamus to the eye. Identifying its cause is a diagnostic challenge since in spite of its apparent lack of clinical importance, HS can be the first or only manifestation of a serious, or even potentially mortal disorder. We present the case of a 19-year-old male patient with a history of nonspecific ocular pains of two months evolution. He attended the emergency ophthalmological clinic where he was diagnosed with an HS as the first clinical manifestation of Hodgkin lymphoma.

Horner's Syndrome as Initial Manifestation of Possible Brachial Plexopathy Neurolymphomatosis

“…Our case represents a rarer subtype of patients who have Horner's syndrome without bulky adenopathy. A 2017 report by Abascal et al documented the onset of ptosis and miosis in a 19 year old male as the initial manifestation of Hodgkin's lymphoma, although the impact of mediastinal adenopathy on the sympathetic chain was unclear (article in Spanish) (16). A separate report described Horner's syndrome in a 35 year old female with cervical adenopathy causing a third order lesion, as confirmed on phenylephrine testing (17).…”