A Case of Pituitary Metastasis of Lung Cancer Presenting as Cavernous Sinus Syndrome / 대한이비인후과학회지

The cavernous sinus contains significant structures such as the internal carotid artery and cranial nerves III to VI. Cavernous sinus lesions may cause ophthalmoplegia, proptosis, and diplopia. We report a 56-year-old woman who presented with throbbing headache and associated right-sided ocular pain. While awaiting imaging studies, she suddenly developed opthalmoplegia and ptosis of the right eye. She had ipsilateral palsy of the third and fourth cranial nerves, while the sixth nerve remained intact. Magnetic resonance imaging revealed a pituitary gland mass extending into the right cavernous sinus with associated sphenoid sinusitis. The patient underwent endoscopic sinus surgery and subsequent pituitary tumor removal by transsphenoidal approach. During preoperative evaluation, a mass was found protruding in her left bronchus. The pituitary tumor pathologic examination revealed metastatic adenocarcinoma of the lung. In this patient, the initial symptoms of lung cancer were headache and cavernous sinus syndrome, which had metastasized to the pituitary gland.

Cavernous Sinus Syndrome Complicating Occlusion of the Internal Carotid Artery by Necrotizing Sinusitis / 대한평형의학회지

Cavernous sinus syndrome is characterized by multiple cranial nerve palsies manifesting with ophthalmoplegia, ptosis, facial sensory loss due to involvement of adjacent cranial nerves. Tumor, trauma, and non-infectious inflammatory disorders are principal causes of cavernous sinus syndrome. Rhinocerebral mucormycosis is one of the fatal causes of cavernous sinus syndrome usually in immunocompromised patients. Here is a case of cavernous sinus syndrome complicating occlusion of the internal carotid artery by necrotizing fungal sinusitis, which is highly suspicious of rhinocerebral mucormycosis with non-immunocompromised state.