ABSTRACT
We herein present the case of a 38-year-old woman with left-sided oculomotor paralysis with ocular pain that developed after a respiratory infection. Her serum was positive for IgM against GM2 and GalNAc-GD1a gangliosides and cytomegalovirus. Thin-slice magnetic resonance imaging revealed enhanced abnormal tissue located primarily in the superolateral part of the left-sided cavernous sinus, which corticosteroids subsequently obscured with immediate resolution of the patient's ocular symptoms. These clinical features were consistent with those of Tolosa-Hunt syndrome (THS). Our findings in the present patient suggest that cytomegalovirus may provoke granuloma formation in the cavernous sinus, as reported in other various organs, thereby leading to the development of THS.
Subject(s)
Cytomegalovirus Infections/complications , Cytomegalovirus/pathogenicity , Respiratory Tract Infections/complications , Tolosa-Hunt Syndrome/etiology , Adult , Antibodies, Viral/blood , Autoantibodies/blood , Autoantibodies/immunology , Cavernous Sinus/virology , Cytomegalovirus/immunology , Cytomegalovirus Infections/immunology , Diplopia/etiology , Female , G(M1) Ganglioside/analogs & derivatives , G(M1) Ganglioside/immunology , G(M2) Ganglioside/immunology , Granuloma/etiology , Granuloma/virology , Humans , Imaging, Three-Dimensional , Immunocompetence , Immunoglobulin M/blood , Macrophages/immunology , Macrophages/pathology , Magnetic Resonance Imaging , Prednisolone/therapeutic use , Respiratory Tract Infections/immunology , Respiratory Tract Infections/virology , Tolosa-Hunt Syndrome/drug therapy , Tolosa-Hunt Syndrome/immunology , Tolosa-Hunt Syndrome/pathology , Tolosa-Hunt Syndrome/virologyABSTRACT
Leiomyosarcomas (LMSs) of the central nervous system are extremely rare; however, they are becoming more prevalent in immunocompromised patients. The authors present the cases of two patients with acquired immunodeficiency syndrome: one with LMS of the thoracic vertebral body and the other with LMS originating from the region of the cavernous sinus. The epidemiological and histological characteristics of LMS and its association with latent Epstein-Barr virus are discussed, as well as the treatments for this neoplasm.
