J Korean Ophthalmol Soc > Volume 55(9); 2014 > Article
Journal of the Korean Ophthalmological Society 2014;55(9):1401-1405.
DOI: https://doi.org/10.3341/jkos.2014.55.9.1401    Published online September 15, 2014.
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
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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