Lynch Shannon C, Lee Andrew G, Graham Scott M, Kirby Patricia A
Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
J Neuroophthalmol. 2005 Dec;25(4):289-92. doi: 10.1097/01.wno.0000189825.62010.93.
An 83-year-old woman presented with right trigeminal paresthesias, upper lid ptosis, and diplopia and was found to have a right third cranial nerve palsy. MRI disclosed a right sphenocavernous mass with speckled high signal on pre-contrast T1 and correspondingly low signal on T2. Endoscopic sphenoidotomy revealed malignant melanoma. The patient underwent radiation therapy with complete and protracted resolution of the palsy. An extensive evaluation for a primary source was negative. The combination of high T1 signal and low T2 signal in a mass should suggest melanin. An exceedingly rare condition, this is the first English report of its presentation with a third cranial nerve palsy.
一名83岁女性出现右侧三叉神经感觉异常、上睑下垂和复视，检查发现右侧动眼神经麻痹。磁共振成像（MRI）显示右侧蝶鞍海绵窦区有一肿块，增强前T1加权像呈斑点状高信号，T2加权像相应呈低信号。经蝶窦内镜手术显示为恶性黑色素瘤。患者接受了放射治疗，麻痹症状完全且持久缓解。对原发灶进行的全面评估结果为阴性。肿块中T1高信号和T2低信号的组合应提示黑色素。这是一种极其罕见的疾病，本文是其伴发动眼神经麻痹的首例英文报道。
