Consider POAML in Progressive Eyelid Swelling, Even in Young WomenEyelid Swelling in a Young Woman Turns Out to Be Rare Lymphoma

Frontiers in Medicine Published October 6, 2026 Study authors: Qiming Zhang, Liying Gu, Jing Yuan, Rui Wang, Yujuan Xu, Qiong Liu, Hongbo Li, Kefeng Shen, Ting Che… DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

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Key Takeaway

Consider POAML in progressive eyelid swelling, even in young women, though evidence is limited to one case.

This is a case report with an accompanying literature review focused on primary ocular adnexal MALT lymphoma (POAML), a rare extranodal lymphoma. The case describes a 35-year-old woman who presented with involvement of the right upper eyelid.

The patient was treated with surgical excision and local radiotherapy (28 Gy). She achieved complete remission, and at 3.5 years of follow-up she remained disease-free. These outcomes apply only to the single reported case; the literature review portion of the text provides general characteristics of POAML rather than pooled or comparative outcome data.

The authors note that the small sample size (a single case) is a limitation. Adverse events, tolerability, and discontinuations were not reported, and funding or conflicts of interest were not reported. No comparator was described.

The authors suggest that POAML should be considered in the differential diagnosis of progressive eyelid swelling, even in young women. Because this evidence comes from one case report, it cannot establish comparative effectiveness or generalizable outcomes, and clinicians should interpret it as hypothesis-generating rather than practice-changing.

When a 35-year-old woman noticed her right upper eyelid kept swelling, the cause turned out to be something rare: a type of cancer called MALT lymphoma growing in the tissue around her eye. This kind of lymphoma, known as primary ocular adnexal MALT lymphoma, or POAML, is uncommon, and doctors often do not suspect it in younger people. Her case is described in a new report.

She had surgery to remove the growth, followed by radiation therapy at a total dose of 28 Gy. The treatment worked. She went into complete remission, meaning doctors could find no sign of the cancer. For the next three and a half years, she stayed disease-free.

The report also includes a review of the medical literature on POAML. That review describes the general features of the disease, but the specific outcome of remission and the 3.5-year follow-up apply only to this one patient. Because it is a single case, the results cannot tell us how well this treatment works for everyone with POAML. No side effects or safety issues were reported in this case.

The main message for doctors is simple: POAML should be on the list of possible causes when someone has progressive eyelid swelling, even if they are young. That does not mean every swollen eyelid is cancer, but it is a reminder to keep looking for answers when symptoms do not go away.

What this means for you:

A rare eyelid lymphoma in a young woman went into remission after surgery and radiation.

Common questions

What is POAML?

POAML stands for primary ocular adnexal MALT lymphoma. It is a rare type of cancer that starts in the tissue around the eye, such as the eyelid. In this case, a 35-year-old woman had POAML in her right upper eyelid. The report says doctors should consider it when someone has progressive eyelid swelling, even in young women.

How was the eyelid lymphoma treated?

The woman had surgery to remove the growth, followed by local radiation therapy at a total dose of 28 Gy. This treatment led to complete remission, meaning no sign of the cancer could be found. She stayed disease-free for 3.5 years after treatment.

Is this treatment safe for everyone with POAML?

This is a single case report, so it cannot tell us how safe or effective the treatment is for everyone. No side effects were reported for this patient, but that does not mean there are none. Anyone with POAML should talk with their doctor about the best approach for their situation.

What are the symptoms of POAML?

The main symptom in this case was progressive swelling of the right upper eyelid. The report notes that POAML should be considered in the differential diagnosis of progressive eyelid swelling, even in young women. If you have ongoing eyelid swelling, see a doctor to find out the cause.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedOct 2026

View Original Abstract ↓

Primary ocular adnexal MALT lymphoma (POAML) is a rare indolent small B-cell lymphoma that primarily involves the orbit, conjunctiva, and lacrimal gland, with a high risk of early misdiagnosis. Herein, we report a rare case of POAML arising in the right upper eyelid of a 35-year-old woman, who presented with progressive eyelid swelling. The diagnosis was established by surgical excision, histopathological examination, and immunoglobulin gene rearrangement analysis. No systemic involvement was identified, and the disease was staged as Ann Arbor IE. The patient received local radiotherapy (28 Gy) and achieved complete remission, remaining disease-free during a 3.5-year follow-up. Literature review indicates that POAML predominantly affects middle-aged and elderly individuals, although younger age and female predominance have been reported in Asian populations. Clinical manifestations vary by site and include orbital mass, proptosis, globe displacement, and ocular motility restriction. Conjunctival lesions typically present as hyperemia, chemosis, or a characteristic “salmon-pink” appearance. Histologically, POAML is characterized by diffuse proliferation of centrocyte-like cells, follicular colonization, and lymphoepithelial lesions (LELs), with CD20 and CD79a positivity. Previous studies have identified recurrent molecular alterations in POAML, including changes affecting the BCR/NF-κB, epigenetic, and NOTCH signaling pathways; rearrangements of MALT1, BIRC3, BCL10, and FOXP1; and chromosomal abnormalities such as trisomy 3 and trisomy 18. Chronic antigenic stimulation associated with infection or autoimmune disease is considered a major predisposing factor. Treatment is stage-dependent, with surgery, radiotherapy, or observation for early-stage disease and immunochemotherapy for advanced disease. This case underscores that POAML should be considered in the differential diagnosis of progressive eyelid swelling, even in young women, as timely and accurate diagnosis and appropriate treatment can lead to a favorable prognosis.

Consider POAML in Progressive Eyelid Swelling, Even in Young WomenEyelid Swelling in a Young Woman Turns Out to Be Rare Lymphoma

Common questions

Study Details

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Consider POAML in Progressive Eyelid Swelling, Even in Young WomenEyelid Swelling in a Young Woman Turns Out to Be Rare Lymphoma

Common questions

Study Details

Biomarkers and clinical factors show statistical associations with sepsis-induced coagulopathy in 37,459 patients

Your Blood May Signal a Deadly Clotting Crisis Before It Strikes

Clinical research that matters. Delivered to your inbox.

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