ASOPRSFall Scientific SymposiumSyllabus
76
YASOPRSEyeOpeners –RapidFireCases andPresentations
Sponsored By:YoungASOPRS (YASOPRS).YASOPRS are defined asASOPRSmembers, age 40 or less.
Moderators: Pete Setabutr,MD, Christina Choe,MD
7:00 am
Intralesional Rituximab: AnEffectiveTherapeuticAlternative for Recurrent
Orbital Lymphoma in aPatient withSevereDryEye
CourtneyKauh, Victor Elner, HakanDemirci. Ophthalmology andVisual Sciences, University ofMichiganKelloggEyeCenter,
AnnArbor,MI, UnitedStates
Introduction:
Mucosa associated lymphoid tissue (MALT) lymphoma is themost common primary ocular adnexal lymphomas
(OAL).
1
Radiation therapy is themainstay treatment for primary OAL but it might have substantial ocular side effects.
2
Systemic
rituximab has been used as an alternative therapy for CD20 positiveOAL in selected cases. However, it is less effective in relapsing
patients.
3
Recent literature has reported the use of intralesional rituximab for treatment of primary OAL.
4,5
We herein report the use of
intralesional rituximab for recurrent MALTOAL in a patient with severe dry eye secondary to Sjogren syndrome.
Methods:
Case report and literature review
Results:
A41- year old femalewith Sjogren’s syndrome presentedwith a 5-month history of bilateral upper eyelid swelling.
Incisional biopsy of the left lacrimal gland revealedMALT lymphoma. Due to bilateral severe dry eyes, the patient declined external
beam radiotherapy and systemic rituximabwas initiated.The patient respondedwell to intravenous rituximab and the follow-upCT
scan revealed decrease in size of both lacrimal glands. Elevenmonths after systemic rituximab therapy, the patient had bilateral
lacrimal gland recurrence.The patient again declined external beam radiotherapy. Intralesional rituximab (50mg /1ml) was injected
into the left lacrimal gland, followed by injection in the right lacrimal gland 7months later. Eighteenmonths follow-up after injection
into left lacrimal gland and 10months after injection into right lacrimal gland, therewas significant interval decrease in size of
bilateral lacrimal glands.
Conclusions:
This case highlights the use of intralesional rituximab as an alternative therapy for recurrent orbital MALT lymphoma in
selected cases.
References:
1. Coupland SE, Hummel M, SteinH. Ocular adnexal lymphomas: five case presentations and a review of the literature.
Surv Ophthalmol. 2002;47(5):470-490.
2.Tsang RW, GospodarowiczMK, PintilieM, et al. Localizedmucosa-associated lymphoid tissue lymphoma treatedwith radiation
therapy has excellent clinical outcome. J ClinOncol. 2003;21(22):4157-4164. doi:10.1200/JCO.2003.06.085.
3. Ferreri AJM, Ponzoni M,Martinelli G, et al. Rituximab in patientswithmucosal-associated lymphoid tissue-type lymphoma of the
ocular adnexa. Haematologica. 2005;90(11):1578-1579.
4. SavinoG, Battendieri R, Balia L, et al. Evaluation of intraorbital injection of rituximab for treatment of primary ocular adnexal
lymphoma: a pilot study. Cancer Sci. 2011;102(8):1565-1567. doi:10.1111/j.1349-7006.2011.01976.x.
5. Laurenti L, De Padua L, Battendieri R, et al. Intralesional administration of rituximab for treatment of CD20 positive orbital
lymphoma: safety and efficacy evaluation. Leuk Res. 2011;35(5):682-684. doi:10.1016/j.leukres.2011.01.030.
DetailedProgram
—Friday,October 17, 2014
