A Case of Sphenoidal Sinus Carcinoma Associated with Partial Oculomotor and Abducens Nerve Palsy

Nam Eok Kim, Soo Jin Kim
2014 Journal of the Korean Ophthalmological Society  
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
more » ... uitary 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.
doi:10.3341/jkos.2014.55.9.1401 fatcat:pqmz7ftqvjbg7kaatr75qkcbjy