# Burkitt's lymphoma presenting as acute dacryocystitis in a 14-year-Old male with ataxia telangiectasia: A case report and review of the literature

## TL;DR

A 14-year-old boy with ataxia telangiectasia presented with eye swelling due to Burkitt lymphoma, highlighting the need to consider cancer in such cases.

## Contribution

This case report highlights an atypical presentation of Burkitt lymphoma in a pediatric patient with ataxia telangiectasia.

## Key findings

- Burkitt lymphoma can present as acute dacryocystitis in pediatric patients with ataxia telangiectasia.
- Orbital and lacrimal duct involvement is rare in pediatric Burkitt lymphoma cases.
- New-onset nasolacrimal duct obstruction in children should include malignancies in the differential diagnosis.

## Abstract

This report describes an atypical presentation of a case of Burkitt lymphoma in a pediatric patient with ataxia telangiectasia.

A 14-year-old boy with a history of AT was referred to our hospital with lower eyelid swelling and medial canthus abscess. On physical examination, movement of the left eye was limited in downgaze and adduction. Two mm proptosis was observed on the left side. Snellen's Visual acuity in the left eye was 8/20. The rest of the examination was normal. Magnetic resonance imaging (MRI) was performed and showed an infiltrative mass in the inferior of the left orbit, left ethmoidal sinus, and maxillary sinus. The patient subsequently underwent an incisional biopsy. The biopsy specimen was sent for histopathologic evaluation. Histopathology was significant for atypical monotonous cell infiltrations in the fibroconnective tissue and the presence of pleomorphic, irregularly shaped nuclei with multiple mitoses. Immunohistochemistry (IHC) findings were consistent with Burkitt's lymphoma, and the patient was referred to the oncology department for chemotherapy and appropriate treatment.

and Significance

Orbital and lacrimal duct involvement is a rare presentation of Burkitt lymphoma especially in the pediatric population. In the new-onset nasolacrimal duct obstruction (NLDO) in a child or teenager, the differential diagnosis should include malignancies, especially leukemia/lymphoma infiltrations.