Management of a Complex Orbital Post-transplantation Lymphoproliferative Disorder: A Case Report and Literature Review.

BACKGROUND/AIM: Post-transplantation lymphoproliferative disorder (PTLD) is an uncommon but serious complication of organ transplantation. Management often requires multiple treatment modalities and reduction in immunosuppressant treatment (RIT). Orbital involvement is rare, and optimal diagnostic and therapeutic approaches remain uncertain.

CASE REPORT: Here, we report a case of localized orbital PTLD that was successfully treated with RIT alone. A 62-year-old man, who had undergone kidney transplantation 18 years prior, presented with left eye pain and proptosis. Imaging revealed an enhancing intraorbital mass extending to the optic nerve and adjacent intracranial structures. Transcranial biopsy confirmed B-cell-type PTLD. The lesion regressed with stepwise RIT alone without additional therapy. The patient showed clear clinical improvement and remained in remission for more than 13 months.

CONCLUSION

This case suggests the potential role of a conservative, individualized, stepwise approach in selected patients with localized orbital PTLD, and may inform management strategies for other localized forms of PTLD.