Chronic Lymphocytic Leukemia with Orbital and Sinonasal Manifestations.

Chronic lymphocytic leukemia (CLL) is a slowly progressive disease most often affecting older patients. Although CLL is typically identified on routine blood work, unique manifestations of the disease have been described both at the time of diagnosis and in the setting of indolent disease. We present on 3 CLL patients with previously stable oncologic disease who presented with orbital pathologies including dacryocystitis, epiphora, proptosis, and diplopia. All 3 cases were found to have recurrences of CLL confirmed on pathology and were managed both surgically and medically with collaboration from ophthalmology and medical oncology. All patients experienced significant improvement in their symptoms. Otolaryngologists should be suspicious of local active disease in CLL patients with orbital complaints. Awareness of rare orbital and sinonasal manifestations of the disease can improve early detection of CLL.