# Diagnostic Challenge of Extranodal Marginal Zone Lymphoma of Extraocular Muscles: A Case Report

## TL;DR

This case report describes a rare lymphoma affecting extraocular muscles and emphasizes the importance of early diagnosis and advanced imaging techniques.

## Contribution

The paper presents a unique case of EMZL in extraocular muscles and highlights the role of navigation systems in accurate diagnosis.

## Key findings

- Extranodal marginal zone lymphoma can present atypically in extraocular muscles.
- Advanced visualization techniques aid in obtaining adequate biopsy samples from delicate orbital tissue.
- Early clinical suspicion and multidisciplinary teamwork improve diagnostic accuracy and patient outcomes.

## Abstract

Background and clinical significance: The current report examines an unusual case of extranodal marginal zone lymphoma (EMZL) affecting only the extraocular muscles. The diagnostic challenges connected to such atypical manifestations are highlighted. The resemblance to inflammatory or infiltrative processes may lead to diagnostic delays; therefore, therapy administration may be withheld. Case presentation: A 77-year-old male was admitted to our hospital with periorbital edema accompanied with vision abnormalities affecting his left eye. The complete diagnostic workup and surgical treatment is presented using a navigation system. Adequate biopsy samples from the delicate orbital tissue can be obtained by utilizing contemporary visualization techniques, particularly navigation systems. The pathology report proved indispensable, with ample raw muscle tissue providing sufficient material from whicha definitive diagnosis was made. The indicated therapy was administered without delay. Conclusions: The uncommon, isolated affection of extraocular muscles by extranodal marginal zone lymphoma is exemplified in this case, highlighting the need for early clinical suspicion in order to differentiate this condition from other more prevalent inflammatory pathologies. The implementation of advanced technologies, such as image-guided navigation systems, alongside a highly skilled multidisciplinary medical team, ensures optimal patient results.