ABSTRACT
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Subject(s)
Humans , Sleep Apnea Syndromes/diagnosis , Eye Diseases/etiology , Sleep Apnea Syndromes/physiopathology , Eye Diseases/physiopathologyABSTRACT
Squamous cell carcinoma (SCC) is the second most common periocular skin cancer. We describe a case of invasive squamous cell carcinoma arising from actinic keratosis and causing orbital and intracranial invasion via perineural spread. Perineural invasion (PNI) is a known feature of SCC and very rarely basal cell carcinomas of the head and neck. A high degree of clinical suspicion is necessary to diagnose PNI. Varied clinical presentations have been described for this form of dissemination, including orbital apex syndrome as in our case. Prognosis is poor, with death resulting in over 50% of cases at 5 years.
Subject(s)
Brain Neoplasms/diagnosis , Carcinoma, Squamous Cell/diagnosis , Skin Neoplasms/diagnosis , Tolosa-Hunt Syndrome/diagnosis , Aged, 80 and over , Brain Neoplasms/etiology , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/therapy , Diagnosis, Differential , Fatal Outcome , Female , Forehead , Humans , Keratosis, Actinic/complications , Neoplasm Invasiveness , Skin Neoplasms/etiology , Skin Neoplasms/therapyABSTRACT
Sleep apnea syndrome is characterised by recurrent episodes of partial or complete upper airway flow interruption during sleep. In the last twenty years, the relationship of sleep apnea with cardiovascular disease has been recognised. More recently, several ocular disorders have been associated with sleep apnea syndrome, including floppy eyelid syndrome, glaucoma, non-arteritic ischemic optic neuropathy and papilledema. Based on the published evidence, we discuss these associations along with the possible pathophysiological mechanisms and clinical management. It is needed that the ophthalmologist, the primary care physician and the sleep physician are aware of this association so that both sleep disorders and the related ophthalmologic disorders can be better diagnosed and treated.
