Midline granuloma presenting as orbital cellulitis

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Abstract
⊎ Background: Lethal midline granuloma usually presents with rhinorrhoea and redness of the skin above the nose. Early ocular symptoms are very rare. We here describe a patient who presented with acute orbital cellulitis. ⊎ Patient: A 73-year-old woman had a 24-h history of severe pain around her left eye. We saw the typical clinical picture of orbital cellulitis. A CT scan revealed a diffuse infiltration of the left upper and lower lid, the anterior orbit and the ethmoidal sinuses. ⊎ Result: On surgical exploration we found a granular, partly necrotic tumour. Histological examination revealed an angiocentric nasal T-cell lymphoma (midline granuloma). ⊎ Conclusion: Midline granuloma should be included in the differential diagnosis of acute orbital cellulitis.