Abstract
We report a patient with rapidly progressive bilateral total ophthalmoplegia due to
bilateral cavernous sinus metastasis from gastric adenocarcinoma. Among a variety
of differential diagnoses, etiology of oculomotoric disorders and ophthalmoplegia
includes the affection of the cranial nerves III, IV, and VI in the cavernous sinus.
Unilateral metastasis in the cavernous sinus occurs quite frequently, however, a bilateral
tumor infiltration of both cavernous sinus is extremely rare. Our patient impressively
demonstrates the relevance of this differential diagnosis of bilateral ophthalmoplegia.
Repeated CCTs and cMRIs were required to find the diagnosis and finally start a therapy,
demonstrating that even with advanced neuroradiological techniques, repetition of
imaging within short intervals can be necessary to detect rapidly developing metastatic
infiltrations as early as possible.
Keywords
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References
- Ocular palsies in the absence of other neurological or ocular symptoms: analysis of 105 cases.J Neurol. 1997; 244: 639-645
- Pearls and oy-sters of localization in ophthalmoparesis.Neurology. 2007; 69: 35-40
- Oculomotor disorders.Semin Neurol. 2007; 27: 244-256
- Bilateral ocular paralysis.Arch Neurol. 2007; 64: 178-180
- Acute bilateral ophthalmoplegia: 60 cases.Neurology. 1986; 36: 279-281
- Acute bilateral ophthalmoplegia secondary to cavernous sinus metastasis: a case report.Neurosurgery. 1992; 31: 783-786
- Relationship between the number of involved cranial nerves and the percentage of lesions located in the cavernous sinus.Eur Neurol. 2003; 49: 98-102
- Cavernous sinus syndrome due to metastatic renal cell carcinoma.South Med J. 1998; 91: 576-579
- Skull-base metastases.J Neurooncol. 2005; 75: 63-69
- Bilateral cavernous sinus metastasis and ophthalmoplegia. Case report.J Neurosurg. 1981; 55: 463-466
- Metastatic disease to the cavernous sinus: clinical syndrome and CT diagnosis.J Comput Assist Tomogr. 1985; 9: 115-120
- Acute bilateral ophthalmoplegia secondary to metastatic prostatic carcinoma. Demonstration on magnetic resonance imaging.J Neuroophthalmol. 1995; 15: 45-47
- Rapidly progressive bilateral ophthalmoplegia and enlarging sellar mass caused by amelanotic melanoma.J Neuro-Ophthalmol. 2006; 26: 49-50
- Metastatic malignant melanoma presenting as a cavernous sinus syndrome.J Neurol. 2004; 251: 224-225
- Radiation therapy for metastases to the base of the skull.Radiology. 1979; 130: 465-468
- Metastasis to the base of the skull: clinical findings in 43 patients.Neurology. 1981; 31: 530-537
- Cancer involving cranial and peripheral nerves.in: Neurologic Complications of Cancer. FA Davis, Philadelphia1995: 172-184
- Cranial nerve involvement with carcinoma of prostate.Urology. 1988; 31: 211-213
Article info
Publication history
Published online: February 02, 2009
Accepted:
January 8,
2009
Received in revised form:
December 23,
2008
Received:
October 8,
2008
Identification
Copyright
© 2008 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
