Lateral Canthotomy and Cantholysis for Spontaneous Retrobulbar Hemorrhage With Normal Intraocular Pressures: Case Report and Review of the Literature

Lem, Melinda; Oyur, Kadir Berat; LaBove, Gabrielle; Hoang-Tran, Cindy; Bhola, Rahul; Pfaff, Miles J.

doi:10.1177/27325016221128771

Cited by 2 publications

(1 citation statement)

References 25 publications

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“…In this case, the patient was taking Warfarin, a potent anticoagulant widely used in medical practice. It is known to increase the risk of hematoma formation, and reports exist of nontraumatic spontaneous retrobulbar hemorrhages associated with its use [9]. The patient initially presented with swelling following facial trauma, which progressively worsened and did not resolve, leading to clinical suspicion of hematoma formation.…”

Section: Discussionmentioning

confidence: 99%

Diffuse Large B-Cell lymphoma Misdiagnosed as a Hematoma: Case Report

Lee,

Yun

2023

Medicina

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Background: Diffuse large B-cell lymphoma (DLBCL), the most common subtype of non-Hodgkin’s lymphoma, often presents diagnostic challenges due to its diverse clinical presentation. We present a case of DLBCL that was initially misdiagnosed as a hematoma, highlighting the importance of considering malignancy when faced with unresponsive soft tissue swelling. Methods: A 76-year-old man presented to the emergency department with right periorbital swelling and ecchymosis following a traumatic injury. Despite ongoing anticoagulant therapy (warfarin) for atrial fibrillation, the symptoms persisted. A CT scan of the facial bones revealed a large, irregular, homogeneous mass. Initially, the clinical history and radiologic findings suggested an extraconal hematoma. As a result, an incision and drainage procedure was performed, and the old blood was evacuated. However, the patient’s symptoms continued to worsen. A follow-up CT scan showed enlargement of the lesion, prompting a surgical excisional biopsy. Results: Pathologic examination of the excised mass revealed a diffuse infiltrate of lymphocytes surrounding the tissue, confirming the diagnosis of diffuse large B-cell lymphoma (DLBCL). The patient was subsequently referred to hematology for further management. Conclusions: Although rare, DLBCL is associated with a challenging prognosis. This case highlights the diagnostic complexities that can arise, particularly when factors such as prior injury and anticoagulant therapy confound the clinical picture. The initial misclassification of the condition as a hematoma led to a delay in diagnosis and the subsequent initiation of treatment. Therefore, it is imperative to remain vigilant and consider malignancy as a potential underlying cause of unresponsive soft tissue swelling. Timely recognition and accurate diagnosis are paramount to improving patient outcomes in DLBCL, an aggressive lymphoma with a diverse clinical presentation.

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Section: Discussionmentioning

confidence: 99%

Diffuse Large B-Cell lymphoma Misdiagnosed as a Hematoma: Case Report

Lee,

Yun

2023

Medicina

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Diffuse Large B-cell Lymphoma Misdiagnosed as a Hematoma: Case Report

Lee,

YUN

2023

Preprint

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Background: Diffuse large B-cell lymphoma is the most common type of non-Hodgkin's lymphoma. Due to the variety of clinical manifestations, accurate diagnosis can be challenging. Here, we present a case of DLBCL that was initially misdiagnosed as a hematoma, highlighting the importance of considering malignancy in the setting of non-responsive soft tissue swelling. Methods: A 76-year-old man presented to the emergency department with right periorbital swelling and ecchymosis. The symptoms first appeared after an injury and did not resolve spontaneously. The patient was taking warfarin for atrial fibrillation. A facial bone CT revealed a large irregular homogeneous mass. An extraconal hematoma was suspected based on clinical history and radiologic findings. Incision and drainage were performed, resulting in evacuation of old blood. Despite continued drainage, the patient's symptoms worsened. A comparison with the previous CT revealed an increase in the size of the lesion. As a result, a surgical excisional biopsy was performed. Results: Biopsy of the mass showed a diffuse infiltrate of lymphocytes around the tissue. The diagnosis of diffuse large B-cell lymphoma was confirmed pathologically. The patient was referred to hematology for further management. Conclusions: DLBCL is a rare disease associated with a poor prognosis. Due to the previous injury and the use of anticoagulants, the patient was initially misdiagnosed as having a hematoma. This delayed the prompt diagnosis and affected the timing of treatment initiation. We must be aware that a malignant mass is a potential cause of unresponsive soft tissue swelling.

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Lateral Canthotomy and Cantholysis for Spontaneous Retrobulbar Hemorrhage With Normal Intraocular Pressures: Case Report and Review of the Literature

Cited by 2 publications

References 25 publications

Diffuse Large B-Cell lymphoma Misdiagnosed as a Hematoma: Case Report

Diffuse Large B-Cell lymphoma Misdiagnosed as a Hematoma: Case Report

Diffuse Large B-cell Lymphoma Misdiagnosed as a Hematoma: Case Report

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