Horner’s syndrome as the initial manifestation of mediastinal Hodgkin lymphoma

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. No subsequent clinical response or outcome is documented in the supplied proof; no additional outcome is asserted. Conclusion: Horner’s syndrome may represent a sentinel sign of mediastinal Hodgkin lymphoma and should prompt a thorough diagnostic workup to facilitate early diagnosis and treatment.