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Case Rep Oncol Med. 2015;2015:249891. doi: 10.1155/2015/249891. Epub 2015 Mar 30.

Tolosa-hunt syndrome in double-hit lymphoma.

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Department of Medicine, Section of Hematology and Oncology, Louisiana State University Health, Shreveport, LA 71103, USA ; Feist-Weiller Cancer Center, Shreveport, LA 71103, USA.
Department of Pathology, Louisiana State University Health, Shreveport, LA 71103, USA.
Department of Radiology, Louisiana State University Health, Shreveport, LA 71103, USA.
Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medical College, New York, NY 10065, USA.


Tolosa-Hunt syndrome (THS) is a painful condition characterized by hemicranial pain, retroorbital pain, loss of vision, oculomotor nerve paralysis, and sensory loss in distribution of ophthalmic and maxillary division of trigeminal nerve. Lymphomas rarely involve cavernous sinus and simulate Tolosa-Hunt syndrome. Here we present a first case of double-hit B cell lymphoma (DHL) relapsing and masquerading as Tolosa-Hunt syndrome. The neurological findings were explained by a lymphomatous infiltration of the right Gasserian ganglion which preceded systemic relapse. As part of this report, the diagnostic criteria for Tolosa-Hunt syndrome and double-hit lymphoma are reviewed and updated treatment recommendations are presented.

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