Spontaneous Regression of a Large-Cell Lymphoma in the Conjunctiva and Orbit

Abstract

Spontaneous and complete regression of malignant neoplasms is extremely unusual. To our knowledge, this case report is the first description of spontaneous regression of an extranodal malignant lymphoma occurring in the conjunctiva and orbit. A 40-year-old woman noticed a pink conjunctival mass at the medial aspect of her left eye that had been present for 3 weeks. She presented on May 5, 2003. Ophthalmologic examination showed a salmon-colored mass along the lateral side of the caruncle. CT revealed a mass in the medial orbit. Surgical biopsy exhibited a malignant lymphoma, diffuse large B-cell type. After biopsy, the tumor spontaneously decreased in size and completely disappeared in 5 weeks. At 6 months' follow-up, the tumor had not recurred.

Lesions of the caruncle: a description of 42 cases and a review of the literature

“…72 Typical clinical presentation is of a slow growing salmon coloured lesion, but definite diagnosis requires always tissue biopsy. Isolated case reports of caruncular myeloproliferative lesions include benign lymphoid hyperplasia, [75][76][77] lymphoma, 78 Langerhans cell histiocytosis, 79,80 and granulocytic sarcoma. 81 Lymphoid tumours of the conjunctiva are reported to be associated with systemic lymphoma in 31% of patients.…”

Spontaneous resolution of untreated diffuse large B‐cell lymphoma of maxillary bone after incisional biopsy

“…The mechanism of regression in lymphoma is postulated to be immune‐mediated secondary to activation from viruses like Epstein‐Barr virus versus local trauma from a biopsy . This has been documented in primary cutaneous DLBCL of the leg, as well as DLBCL of the bladder, breast, and conjunctiva . Extranodal onset may confer a greater likelihood of spontaneous regression .…”

Spontaneous Regression of Bilateral Conjunctival Extranodal Marginal Zone B-cell Lymphoma of Mucosa-Associated Lymphoid Tissue

“…3 Helicobacter pylori-recognizing T cells might control the proliferation of lymphoma cells. In the ophthalmological field, orbital/conjunctival large-cell lymphoma has been reported to regress spontaneously, 4 whereas the regression of orbital/ conjunctival MALT lymphoma has been related to treatment with antibiotics. 5 Furthermore, a recent report described the detection of Chlamydia pneumoniae DNA by polymerase chain reaction in bilateral orbital MALT lymphoma, 6 suggesting the role of antibiotics in the regression of lymphomas.…”