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鼻窦尤因肉瘤继发压迫性视神经病变:一例报告

Compressive optic neuropathy secondary to Ewing sarcoma in the paranasal sinus: A case report.

作者信息

Lee Min Jee, Kang Min Ho, Yeom Jong Hun, Yeom Hoseok, Seong Mincheol, Cho Heeyoon, Shin Yong Un

机构信息

Department of Ophthalmology.

Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.

出版信息

Medicine (Baltimore). 2018 Nov;97(44):e13027. doi: 10.1097/MD.0000000000013027.

Abstract

RATIONALE

Ewing sarcoma localized in the paranasal sinuses, compressing the optic nerve, is very rare, with no prior case reports PATIENT CONCERNS:: A 68-year-old woman presented with decreased visual acuity in her left eye and paresthesia of the left face. Brain magnetic resonance imaging showed heterogeneously enhancing mass in the left paranasal sinuses with adjacent bone destruction, extending to the extraocular muscles and optic nerve of the left orbit. A biopsy of the nasal cavity confirmed Ewing sarcoma.

DIAGNOSIS

Compressive optic neuropathy secondary to Ewing sarcoma in the paranasal sinuses.

INTERVENTION

Neoadjuvant chemotherapy and radiotherapy were performed.

OUTCOMES

Resolution of the tumor and increased visual acuity and field of the left eye.

LESSONS

Primary head and neck Ewing sarcoma can lead to compressive optic neuropathy, but the tumor responded well to the chemotherapy. Early diagnosis and immediate treatment by close cooperation between the ophthalmologist and oncologist can prevent from permanent visual loss.

摘要

理论依据

局限于鼻窦并压迫视神经的尤因肉瘤非常罕见,此前尚无病例报告。

患者情况

一名68岁女性,左眼视力下降,左侧面部感觉异常。脑部磁共振成像显示左侧鼻窦有不均匀强化肿块,伴有相邻骨质破坏,延伸至左侧眼眶的眼外肌和视神经。鼻腔活检确诊为尤因肉瘤。

诊断

鼻窦尤因肉瘤继发压迫性视神经病变。

干预措施

进行了新辅助化疗和放疗。

结果

肿瘤消退,左眼视力和视野改善。

经验教训

原发性头颈部尤因肉瘤可导致压迫性视神经病变,但该肿瘤对化疗反应良好。眼科医生和肿瘤学家密切合作进行早期诊断和及时治疗可预防永久性视力丧失。

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