{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T08:14:22Z","timestamp":1770711262802,"version":"3.49.0"},"reference-count":18,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and clinical significance: The current report examines an unusual case of extranodal marginal zone lymphoma (EMZL) affecting only the extraocular muscles. The diagnostic challenges connected to such atypical manifestations are highlighted. The resemblance to inflammatory or infiltrative processes may lead to diagnostic delays; therefore, therapy administration may be withheld. Case presentation: A 77-year-old male was admitted to our hospital with periorbital edema accompanied with vision abnormalities affecting his left eye. The complete diagnostic workup and surgical treatment is presented using a navigation system. Adequate biopsy samples from the delicate orbital tissue can be obtained by utilizing contemporary visualization techniques, particularly navigation systems. The pathology report proved indispensable, with ample raw muscle tissue providing sufficient material from whicha definitive diagnosis was made. The indicated therapy was administered without delay. Conclusions: The uncommon, isolated affection of extraocular muscles by extranodal marginal zone lymphoma is exemplified in this case, highlighting the need for early clinical suspicion in order to differentiate this condition from other more prevalent inflammatory pathologies. The implementation of advanced technologies, such as image-guided navigation systems, alongside a highly skilled multidisciplinary medical team, ensures optimal patient results.<\/jats:p>","DOI":"10.3390\/reports9010055","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T12:42:42Z","timestamp":1770640962000},"page":"55","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Challenge of Extranodal Marginal Zone Lymphoma of Extraocular Muscles: A Case Report"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2850-8290","authenticated-orcid":false,"given":"Vaia-Aikaterini","family":"Alexoudi","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"},{"name":"Specialized Cancer Treatment and Reconstruction Centre, \u201cGeorge Papanikolaou\u201d General Hospital of Thessaloniki, Exochi, 57010 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2508-0396","authenticated-orcid":false,"given":"Dimitris","family":"Tatsis","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"},{"name":"Specialized Cancer Treatment and Reconstruction Centre, \u201cGeorge Papanikolaou\u201d General Hospital of Thessaloniki, Exochi, 57010 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3809-0761","authenticated-orcid":false,"given":"Christos","family":"Varelas","sequence":"additional","affiliation":[{"name":"Hematology & HCT Unit, George Papanikolaou Hospital, Exochi, 57010 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Vaxtsevanos","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"},{"name":"Specialized Cancer Treatment and Reconstruction Centre, \u201cGeorge Papanikolaou\u201d General Hospital of Thessaloniki, Exochi, 57010 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5374-1772","authenticated-orcid":false,"given":"Aggeliki","family":"Cheva","sequence":"additional","affiliation":[{"name":"Pathology Department, Faculty of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Rocco, A.D., Petrucci, L., Assanto, G.M., Martelli, M., and Pulsoni, A. (2022). Extranodal Marginal Zone Lymphoma: Pathogenesis, Diagnosis and Treatment. Cancers, 14.","DOI":"10.3390\/cancers14071742"},{"key":"ref_2","first-page":"77","article-title":"MALT Lymphoma as a Model of Chronic Inflammation-Induced Gastric Tumor Development","volume":"421","author":"Marcelis","year":"2019","journal-title":"Curr. Top. Microbiol. Immunol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s40364-016-0068-1","article-title":"Gastric Mucosa-Associated Lymphoid Tissue Lymphoma and Helicobacter Pylori Infection: A Review of Current Diagnosis and Management","volume":"4","author":"Hu","year":"2016","journal-title":"Biomark. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"186","DOI":"10.3109\/01676830.2011.558975","article-title":"Extraocular Muscle Involvement in MALT Lymphomas","volume":"30","author":"Abdulkader","year":"2011","journal-title":"Orbit"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Guo, Q., Liu, R., Zhang, X., Yang, B., and Ma, J. (2022). Local Recurrence as Extraocular Muscle Lymphoma after 6\u2009Years of Chronic Myositis: A Case Report. BMC Ophthalmol., 22.","DOI":"10.1186\/s12886-022-02623-4"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1182\/blood-2008-12-195453","article-title":"Extranodal Marginal Zone Lymphoma of the Ocular Adnexa","volume":"114","author":"Stefanovic","year":"2009","journal-title":"Blood"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s40662-019-0146-1","article-title":"Classification, Diagnosis, and Management of Conjunctival Lymphoma","volume":"6","author":"Tanenbaum","year":"2019","journal-title":"Eye Vis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"21875","DOI":"10.1038\/s41598-020-78830-0","article-title":"Radiologic Imaging Shows Variable Accuracy in Diagnosing Orbital Inflammatory Disease and Assessing Its Activity","volume":"10","author":"Lee","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1159\/000525632","article-title":"Bilateral Orbital Inflammation as a Manifestation of Paraneoplastic Syndrome","volume":"13","author":"Yoshida","year":"2022","journal-title":"Case Rep. Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.sjopt.2018.02.003","article-title":"Isolated Superior Oblique Muscle Extranodal Marginal Zone B Cell Lymphoma: Case Report","volume":"32","author":"Alhammad","year":"2018","journal-title":"Saudi J. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"65","DOI":"10.31288\/oftalmolzh202256570","article-title":"Non-Hodgkin B-Cell MALT Lymphoma of Marginal Zone of the Upper Eyelid","volume":"100","author":"Malachkova","year":"2022","journal-title":"Oftalmol. Zhurnal"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Wen, Y.-C., Huang, T., Tsai, W., and Lai, S. (2024). Rare Orbital Involvement Originating from Extranodal Marginal Zone Lymphoma. Medicina, 60.","DOI":"10.3390\/medicina60050706"},{"key":"ref_13","first-page":"1","article-title":"Mucosa Associated Lymphoid Tissue (MALT): A Clinical Overview of Orbital Lymphoma","volume":"3","author":"Njeru","year":"2025","journal-title":"J. Med. Optom."},{"key":"ref_14","first-page":"91","article-title":"Augmented Reality and Optical Navigation Assisted Orbital Surgery: A Novel Integrated Workflow","volume":"10","author":"Tonchev","year":"2024","journal-title":"Innov. Surg. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Nasir, N., Cercenelli, L., Tarsitano, A., and Marcelli, E. (2023). Augmented Reality for Orthopedic and Maxillofacial Oncological Surgery: A Systematic Review Focusing on Both Clinical and Technical Aspects. Front. Bioeng. Biotechnol., 11.","DOI":"10.3389\/fbioe.2023.1276338"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Sahovaler, A., Chan, H., Gualtieri, T., Daly, M.J., Ferrari, M., Vannelli, C., Eu, D., Manojlovic-Kolarski, M., Orzell, S., and Taboni, S. (2021). Augmented Reality and Intraoperative Navigation in Sinonasal Malignancies: A Preclinical Study. Front. Oncol., 11.","DOI":"10.3389\/fonc.2021.723509"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/1477-7819-11-73","article-title":"Orbital Lymphoma: Diagnostic Approach and Treatment Outcome","volume":"11","author":"Eckardt","year":"2013","journal-title":"World J. Surg. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.critrevonc.2016.01.009","article-title":"Review Article: Mucosa-Associated Lymphoid Tissue (MALT)-Type Lymphoma of Ocular Adnexa. Biology and Treatment","volume":"100","author":"Annibali","year":"2016","journal-title":"Crit. Rev. Oncol. Hematol."}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/1\/55\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T13:31:54Z","timestamp":1770643914000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/1\/55"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,9]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["reports9010055"],"URL":"https:\/\/doi.org\/10.3390\/reports9010055","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,9]]}}}