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

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.

A Case of Eyeball Movement Disorder due to a Chondrosarcoma in the Cavernous Sinus

PURPOSE: To report a patient with an eyeball movement disorder due to a chondrosarcoma in the left cavernous sinus. CASE SUMMARY: A 33-year-old woman visited our clinic complaining of diplopia she hand for one month. She had been undergone two operation for the removal of chondrosarcoma in the left cavernous sinus, and she had left esotropia of 25 prism diopters in the primary position and limited abduction of approximately -1.5 in the left eye. Therefore she was treated with radiotherapy for six weeks. Three weeks after radiotherapy she had esotropia of 2 prism diopters in the primary position and limited abduction of approximately -1 in the left eye. Six weeks later, only limited abduction of approximately -0.5 in the left eye was present. CONCLUSIONS: Eyeball movement disorders, like abducent nerve palsy, may develop as a result of tumors of the cavernous sinus and may be improved by the appropriate treatment of such tumors.