case_images: PMC7849864_01
case_images: (a) Pre-operative clinical photograph showing left eye ptosis. (b) Mulberry-like mass lesion in the left superior fornix with overlying dilated and tortuous blood vessels
case_images: SJO-34-70-g001.jpg
case_images: PMC7849864_01_SJO-34-70-g001.jpg
case_images: F1
case_images: A 69-year-old male presented with complains of painless progressive swelling inthe left eye for 6 months [Figure 1a]. On examination, reddish, mulberry like mass lesion was seen in superior fornix withoverlying dilated tortuous blood vessels, blanching on digital pressure, but showing no variation with the Valsalva maneuver [Figure 1b].
case_images: (a) T1 weighted Magnetic Resonance Imaging (MRI) showing a well circumscribed isointense lesion in left superior obit. SR-LPS complex cannot be identified separately. (b) T2 weighted images showing heterogenous centrally hyperintense but peripherally hyopintense lesion. (c) Post Contrast MRI showing moderate heterogenous enhancement
case_images: SJO-34-70-g002.jpg
case_images: PMC7849864_01_SJO-34-70-g002.jpg
case_images: F2
case_images: On T1weighted images, the mass was isointense whereas on T2 weighted images a central hyperintense area with peripheral hypointensity was seen [Figure 2a-c].
case_images: (a) Carotid angiogram showing small tumor blush in left supraorbital region (fed by anterior branch of middle-meningeal artery (Arrow). (b) Post embolization angiogram showing complete obliteration of tumor blush
case_images: SJO-34-70-g003.jpg
case_images: PMC7849864_01_SJO-34-70-g003.jpg
case_images: F3
case_images: Post embolization angiogram showed complete obliteration of tumor blush [Figure 3a and b].
case_images: (a) Peroperative appearance of the lesion inseparable from sr-LPS complex (SR hooked by squint hook). (b) Photomicrograph showing large lymphoid cells arranged around blood vessels (Hematoxylin& Eosin Stain; 100)
case_images: SJO-34-70-g004.jpg
case_images: PMC7849864_01_SJO-34-70-g004.jpg
case_images: F4
case_images: The SR-LPS complex could not be separated from the mass and was excised partially along with the lesion [Figure 4a]. Histopathological examination was suggestive of diffuse non-Hodgkin's lym- phoma [Figure 4b].
case_images: Postoperative clinical photograph of the patient after excision of the mass showing left eye complete ptosis
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case_images: PMC7849864_01_SJO-34-70-g005.jpg
case_images: F5
case_images: The patient had complete ptosis of the left upper eyelid for which he was advised surgical correction [Figure 5].