Maria Bader

A 64-year-old Middle Eastern man with no history of malignancy presented with a 5-month history of bilateral painless upper eyelid swelling and ptosis (Fig. 1 shows the left eyelid; image has been cropped to maintain patient anonymity). About 3 weeks prior to his consultation, the patient also noticed mild enophthalmos. This was a subjective observation made by the patient and not clinically measured during examination. The patient denied any weight loss, anorexia, night sweats, or fever.