Park Young Mok, Cho Jun Hyung, Cho Jae Yong, Huh Ji Soon, Ahn Jung Yong
Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
World J Surg Oncol. 2007 Aug 3;5:86. doi: 10.1186/1477-7819-5-86.
Solitary involvement of the sphenoid sinus has rarely been reported in non-Hodgkin's lymphoma. Isolated oculomotor nerve palsy is uncommon as an initial presentation of malignant tumors of the sphenoid sinus.
A 53-year-old woman presented with a three-month history of headache and diplopia. Neurological examination revealed complete left oculomotor nerve palsy. Magnetic Resonance Imaging (MRI) demonstrated a homogenous soft-tissue lesion occupying the left sphenoid sinus and invading the left cavernous sinus. The patient underwent transsphenoidal biopsy and the lesion was histologically diagnosed as non-Hodgkin's lymphoma, diffuse large B-cell type. Tumor cells were positive for CD20 and negative for CD3. Following six cycles of chemotherapy, the left oculomotor nerve palsy that had been previously observed was completely resolved. There was no enhancing lesion noted on follow-up MRI.
It is important to recognize that non-Hodgkin's lymphoma of the sphenoid sinus can present with isolated oculomotor nerve palsy, although it is extremely rare. The cranial nerve deficits can resolve dramatically after chemotherapy.
蝶窦孤立受累在非霍奇金淋巴瘤中鲜有报道。孤立性动眼神经麻痹作为蝶窦恶性肿瘤的初始表现并不常见。
一名53岁女性，有三个月头痛和复视病史。神经系统检查显示左侧动眼神经完全麻痹。磁共振成像（MRI）显示一个均匀的软组织病变占据左侧蝶窦并侵犯左侧海绵窦。患者接受了经蝶窦活检，病变经组织学诊断为非霍奇金淋巴瘤，弥漫大B细胞型。肿瘤细胞CD20阳性，CD3阴性。经过六个周期的化疗，先前观察到的左侧动眼神经麻痹完全缓解。随访MRI未发现强化病变。
重要的是要认识到，蝶窦非霍奇金淋巴瘤可表现为孤立性动眼神经麻痹，尽管极为罕见。化疗后颅神经缺损可显著缓解。
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