The Riddle of the Double Vision-A Rare Case of Intracranial Tumor: When Imaging Resolves the Mystery.
Radina KirkovaSvetla DinevaElisa StradiottoIvan TanevAlessandra Di MariaPublished in: Diagnostics (Basel, Switzerland) (2024)
A 77-year-old-man with arterial hypertension, diabetes mellitus type II presented at our clinic for a routine ophthalmological exam. He complained of intermittent double vision. The ophthalmic examination revealed paralysis of III (n. oculomotorius) and VI (n. abducens) cranial nerves with ptosis, deficit in elevation and abduction of the left eye. The patient underwent urgent MRI imaging of the brain/orbits and paranasal sinuses, and urgent neurological assessment. MRI revealed a volume-occupying process, starting from the posterior wall of the left maxillary sinus with perineural diffusion and involvement of the homolateral trigeminal nerve, intracranial spread in the medial cranial fossa and involvement of the cavernous, sphenoidal sinuses and the orbital apex on the left side. Biopsy was performed, and the histology resulted in sinonasal squamous cell carcinoma with intracranial spread.
Keyphrases
- rare case
- squamous cell carcinoma
- arterial hypertension
- high resolution
- contrast enhanced
- magnetic resonance imaging
- optic nerve
- single cell
- primary care
- diffusion weighted imaging
- computed tomography
- case report
- high intensity
- type diabetes
- radiation therapy
- cerebral ischemia
- metabolic syndrome
- spinal cord injury
- peripheral nerve
- locally advanced
- glycemic control
- weight loss
- subarachnoid hemorrhage