ORBITAL MYOSITIS AS A PARANEOPLASTIC-SYNDROME

We describe a patient with bilateral orbital myositis, multiple crania l neuropathies, a sensory polyneuropathy, serum and cerebrospinal flui d paraproteins, and high-grade non-Hodgkin's lymphoma. Neurologic symp toms began more than 1 year before diagnosis of the lymphoma. Results of extraocular muscle biopsy showed extensive destruction of myofibers and granulomatous features, with no evidence of direct tumor involvem ent. The cranial neuropathies and orbital myositis improved with immun osuppressive therapy, while the patient's tumor progressed. We believe the orbital myositis and the multiple neurologic abnormalities were p araneoplastic effects of the lymphoma. To our knowledge, this is the f irst case of orbital myositis identified as a paraneoplastic syndrome.