Epiphora as the Presenting Sign of Relapsed Non-Hodgkin Lymphoma in a Child with Bruton Agammaglobulinemia

Abstract

Purpose Primary or secondary infiltration of the lacrimal drainage system by a lymphoid neoplasm is rare in children. Primary immunodeficiencies are characterized by occurrence of unusual malignancies at unexpected locations in the pediatric age group. Methods Case report. Results A 12-year-old boy with a history of Bruton agammaglobulinemia and non-Hodgkin lymphoma (NHL) that primarily originated in the perianal region was referred to our oculoplastics department for persistent epiphora. Computed tomography scan and nasal endoscopy revealed relapse of NHL in the inferior portion of the nasolacrimal duct. Complete remission was achieved with chemotherapy. Conclusions Epiphora could be the initial manifestation of a relapse or a recurrence of an underlying malignancy in the pediatric population with predisposing immunodeficiency.