Acute visual loss in a head and neck cancer patient with ocular metastasis and sphenoid pyocele.
We report an extremely rare case of head and neck cancer patient with right acute visual loss by ocular metastasis after excluding compressive optic neuropathy by endoscopic decompression of the sphenoid pyocele. The ocular metastasis from head and neck cancer had been reported only once in English literatures. Besides, the patient combined with sphenoid pyocele increases the difficulty in differentiating the etiologies. In this article, we describe the history of this patient and discuss the possible cause of acute visual loss and the treatment strategy. Although to differentiate the etiology of acute visual loss between metastatic malignancy and compressive optic neuropathy remain difficult, treatment strategy should focus on rescuing visual acuity. Ocular metastases should always keep in mind when acute visual loss is encountered in patients with previously treated head and neck squamous cell carcinoma.
Fang
Ku-Hao
KH
Department of Otolaryngology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan.
Chen
Chin-Kuo
CK
Hao
Sheng-Po
SP
D000038:Abscess / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D001766:Blindness / Q000209:etiology*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D018289:Carcinoma, Verrucous / Q000175:diagnosis / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D002830:Choroid Neoplasms / Q000175:diagnosis / Q000532:radiotherapy / Q000556:secondary*; D019299:Decompression, Surgical; D003937:Diagnosis, Differential; D004724:Endoscopy; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000601:surgery; D007825:Laryngectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis / Q000601:surgery; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000601:surgery*; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D009887:Ophthalmoscopy; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D010039:Otorhinolaryngologic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D010166:Palliative Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000532:radiotherapy; D012086:Reoperation; D015524:Sphenoid Sinusitis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery