Exophthalmos revealing a Burkitt's lymphoma

1. Hassan Ali
2. Hind Kharbouch
3. Bekkay Rezzoug
4. El Hassan Abdallah
5. Charif Chefchaouni
6. Amina Berraho

Service d' ophthalmologie B, Hopital des specialties, Rabat, Morroco

Purpose
This work reports a rare case of tumoral exophtalmos; the Burkitt's lymphoma in its sporadic form.

Methods & Results
3-year-old child hade presented for a month occasional abdominal pains with inflammatory exophtalmos and chemosis of the right eye. The scanner showed an intra-orbital compressive and osteolytic process of superior and internal location repulsing the globe with extension to the brain and nasopharynx. In front of the atypical clinical and radiological aspect and the not decisive biopsy, the realization of the medullogram allowed the diagnosis. The extension check-up showed an associated bilateral renal infiltration. The treatment adapted was a polychimiotherapy.

Discussion
The Burkitt's lymphoma is a diagnostic and therapeutic emergency. The orbital localization of its sporadic shape is very rare, presented, mostly, by a one-sided exophtalmos of acute installation. The diagnosis is based on the cyto-histological analysis of a ganglionic biopsy, of an accessible superficial or deep tumoral lesion, a medullogram or cerebrospinal liquid. The rhabdomyosarcoma was spread thanks to the biopsy and the medullogram allowed the diagnosis .The oculo-cerebral extension corresponds to the IVth class of Murphy classification and to the C therapeutic group of which the treatment is long and the prognosis depends on the speed of instauration of the polychimiotherapy and on the capacity of the patient to support it.

Conclusion
Although the orbital localization of the sporadic Burkitt's lymphoma is rare, this diagnosis must be suspected in front of any one-sided exophtalmos of acute installation of the child, to establish a premature polychimiotherapy capable of improving the prognosis.