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Case Report
Horner’s syndrome as the initial manifestation of mediastinal Hodgkin lymphoma
1 Department of Neurology, Hospital CIMA Sanitas, Passeig de Manuel Girona 33, Sarrià–Sant Gervasi, 08034 Barcelona, Spain
2 Department of Hematology, Hospital CIMA Sanitas, Passeig de Manuel Girona 33, Sarrià–Sant Gervasi, 08034 Barcelona, Spain
Address correspondence to:
Francisco Javier Ruiz Miyares
Department of Neurology, Hospital CIMA Sanitas, Passeig de Manuel Girona 33, Sarrià–Sant Gervasi, 08034 Barcelona,
Spain
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Article ID: 100087Z09FM2026
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Miyares FJR, Appiani FE, Márquez FKM, De Gracia SR, Donaire AJ. Horner’s syndrome as the initial manifestation of mediastinal Hodgkin lymphoma. J Case Rep Images Med 2026;12(2):4–7.ABSTRACT
Introduction: Horner’s syndrome (HS) is characterized by ptosis, miosis, and ipsilateral facial anhidrosis resulting from disruption of the oculosympathetic pathway. Its association with mediastinal Hodgkin lymphoma is exceptionally rare.
Case Report: A 33-year-old man with a history of severe facial trauma sustained in a motorcycle accident 18 months earlier presented with a one-month history of left-sided ptosis and miosis. Brain magnetic resonance imaging (MRI) was unremarkable. Angio-computed tomography (CT) and positron emission tomography (PET)-CT revealed a large anterior mediastinal mass with hypermetabolic supradiaphragmatic lymphadenopathy. Histopathological examination of a lymph node biopsy confirmed classical Hodgkin lymphoma, nodular sclerosis subtype. The patient initiated brentuximab-AVD following sperm cryopreservation. The patient was subsequently lost to follow-up; therefore, treatment response and clinical outcome could not be assessed.
Horner’s syndrome may represeConclusion: nt a sentinel sign of mediastinal Hodgkin lymphoma and should prompt a thorough diagnostic workup to facilitate early diagnosis and treatment.
Keywords: Classical Hodgkin lymphoma, Early diagnosis, Horner’s syndrome, Mediastinum
SUPPORTING INFORMATION
Author Contributions
Francisco Javier Ruiz Miyares - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Franco Emanuel Appiani - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Fiorella Karina Miraval Márquez - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Silvia Ruiz De Gracia - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Antonio Jesús Donaire - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionFrancisco Javier Ruiz Miyares, MD, is the guarantor of this submission and accepts full responsibility for the integrity and accuracy of the work.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2026 Francisco Javier Ruiz Miyares et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
