A childhood cavernous conundrum.
A 9-year-old boy presented with a left-sided "tooth ache." Subsequently, he developed new onset vertical diplopia. He was found to have a left cranial nerve three palsy. Cranial magnetic resonance imaging showed bilateral cavernous sinus lesions that were initially interpreted as possible "cavernous sinus thrombosis." Subsequent blood smear and bone marrow biopsy disclosed Burkitt lymphoma. He was treated with chemotherapy and made a dramatic recovery. Burkitt lymphoma rarely presents with a third nerve palsy but should be considered in the differential diagnosis of childhood cavernous sinus syndrome.
Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
Andrew G
AG
Lee
Susan J
SJ
Quick
Grant T
GT
Liu
Susan R
SR
Rheingold
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002051:Burkitt Lymphoma / Q000175:diagnosis* / Q000188:drug therapy; D002426:Cavernous Sinus / Q000473:pathology*; D002648:Child; D003520:Cyclophosphamide / Q000008:administration & dosage; D003937:Diagnosis, Differential; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008279:Magnetic Resonance Imaging; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D015840:Oculomotor Nerve Diseases / Q000175:diagnosis* / Q000188:drug therapy; D010254:Paranasal Sinus Diseases / Q000175:diagnosis* / Q000188:drug therapy; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D003520:Cyclophosphamide; D002955:Leucovorin; D008727:Methotrexate