Non-Hodgkin's lymphoma of the sphenoid sinus presenting as isolated oculomotor nerve palsy.
BACKGROUND
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.


METHODS
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.


CONCLUSIONS
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.
Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea. youngmok76@hanmail.net
Young Mok
YM
Park
Jun Hyung
JH
Cho
Jae Yong
JY
Cho
Ji Soon
JS
Huh
Jung Yong
JY
Ahn
D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D015840:Oculomotor Nerve Diseases / Q000209:etiology*; D010255:Paranasal Sinus Neoplasms / Q000150:complications* / Q000175:diagnosis; D013101:Sphenoid Sinus