伴有海绵窦受累并表现为动眼神经麻痹的多形性低度恶性腺癌。
Polymorphous low-grade adenocarcinoma with cavernous sinus involvement presenting as third nerve palsy.
作者信息
Chan Alison X, Chang Aimee, Do Jiun L, Koo Sonya J, Lin Grace, Welsbie Derek S
机构信息
Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA.
Department of Radiology, University of California San Diego, La Jolla, CA, USA.
出版信息
Am J Ophthalmol Case Rep. 2022 Mar 11;26:101460. doi: 10.1016/j.ajoc.2022.101460. eCollection 2022 Jun.
PURPOSE
Polymorphous low-grade adenocarcinoma is a tumor of the salivary glands that typically localizes within the oral cavity. We present a case of isolated third cranial nerve palsy as the initial presentation of polymorphous low-grade adenocarcinoma involving the left cavernous sinus in a patient status post glaucoma surgery.
OBSERVATIONS
A 68-year-old woman status post glaucoma drainage device implantation in her left eye presented with an isolated left third nerve palsy ten weeks postoperatively. Differential diagnoses included microvascular ischemic neuropathy, postoperative ptosis, and compressive mass. MRI revealed a left cavernous sinus mass, and subsequent excisional biopsy revealed a diagnosis of polymorphous low-grade adenocarcinoma.
CONCLUSIONS
There are few cases reporting polymorphous low-grade adenocarcinoma originating from and extending beyond the nasopharynx. This report emphasizes an unexpected neuro-ophthalmic manifestation of this salivary gland tumor.
目的
多形性低度恶性腺癌是一种唾液腺肿瘤，通常位于口腔内。我们报告一例青光眼手术后患者，以孤立性动眼神经麻痹为首发表现，其多形性低度恶性腺癌累及左侧海绵窦。
观察结果
一名68岁女性，左眼植入青光眼引流装置后10周出现孤立性左侧动眼神经麻痹。鉴别诊断包括微血管缺血性神经病变、术后上睑下垂和占位性肿块。磁共振成像（MRI）显示左侧海绵窦有肿块，随后的切除活检确诊为多形性低度恶性腺癌。
结论
很少有报告称多形性低度恶性腺癌起源于鼻咽部并超出鼻咽部范围。本报告强调了这种唾液腺肿瘤意想不到的神经眼科表现。
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