A Case of Sphenoidal Sinus Carcinoma Associated with Partial Oculomotor and Abducens Nerve Palsy. |
Nam Eok Kim, Soo Jin Kim |
Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea. pearlsj@hanmail.net |
동안신경 부분마비 및 외향신경마비를 보인 나비굴 암종 1예 |
김남억⋅김수진 |
Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea |
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Abstract |
PURPOSE To report a rare case of a patient with diplopia due to a mass in the sphenoidal sinus, histologically diagnosed as carcinoma. CASE SUMMARY: A 57-year-old male visited our clinic complaining of diplopia and ptosis for 10 days. He had esotropia 45 prism diopters in the primary position, markedly limited abduction, and a 4 mm dilated pupil in the right eye compared with a 2 mm pupil in the left eye. Enhanced magnetic resonance imaging revealed a sphenoidal sinus mass extended into the pituitary gland and sella turcica with homogeneous intense enhancement. Metastatic workups, including CT of the head, neck, chest, and abdomen were unremarkable. He underwent a transsphenoidal approach mass debulking surgery followed by radiotherapy for 6 weeks. Histological findings were compatible with carcinoma. Six weeks after radiotherapy he had esotropia of 20 prism diopters in the primary position. Abduction limitation was partially recovered postoperatively. CONCLUSIONS: Diplopia may develop as a result of multiple cranial nerve palsy due to carcinoma in the sphenoidal sinus and may be improved by debulking surgery and radiation treatment. |
Key Words:
Debulking surgery;Limitation of abduction;Sphenoidal sinus carcinoma |
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