Orbital Apex Syndrome Associated with Peripheral T-Cell Lymphoma and Uterine Leiomyosarcoma: A Report of Synchronous Primary Tumors.

Orbital apex syndrome is an uncommon neuro-ophthalmologic entity caused by lesions affecting the orbital apex and associated with inflammatory, infectious, vascular, and neoplastic processes. Synchronous tumors represent an exceptional condition defined by the simultaneous coexistence of neoplasms with different histological origins. We present the case of a 45-year-old woman with progressive visual acuity loss, painful ophthalmoplegia, facial hypoesthesia, and a right relative afferent pupillary defect, associated with an oropharyngeal lesion, nasal obstruction, dysphagia, and dysphonia. Histopathological analysis confirmed peripheral T-cell lymphoma. Concurrently, the patient developed persistent metrorrhagia, hypogastric pain, and mucopurulent vaginal discharge; cervical biopsy demonstrated a mesenchymal neoplasm compatible with leiomyosarcoma. Following multidisciplinary management, the patient showed favorable clinical evolution with partial visual recovery. This case highlights the importance of early recognition of orbital apex syndrome as a manifestation of aggressive neoplasms and underscores the value of a comprehensive multidisciplinary approach in complex oncologic scenarios.