title: Isolated oculomotor nerve palsy as a paraneoplastic manifestation of gastric diffuse large B-cell lymphoma: A case report.
abstract: Isolated oculomotor nerve palsy (ONP) is rare. The major causes are aneurysm of the posterior communicating artery, microvascular ischemia, neoplasm, inflammation and trauma. The present study reports the case of a 72-year-old female with left isolated pupil-sparing ONP and severe anemia as the initial manifestations of gastric diffuse large B-cell lymphoma (DLBCL). Systemic chemotherapy without any central nervous system (CNS)-directed treatment led to a complete resolution of the ONP, suggesting that it was most likely to be a paraneoplastic phenomenon. If CNS involvement cannot be demonstrated by brain magnetic resonance imaging and cerebrospinal fluid assessment, the present case suggests that it may be acceptable to omit CNS-directed therapy in such cases of ONP, since it may be paraneoplastic in nature and may resolve following successful treatment of the underlying malignancy.
authors.affiliation: Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan, R.O.C.
authors.forename: Shang-Yih
authors.initials: SY
authors.lastname: Yan
authors.affiliation: Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan, R.O.C.
authors.forename: Yi-Jen
authors.initials: YJ
authors.lastname: Peng
authors.affiliation: Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan, R.O.C.
authors.forename: Chun-Shu
authors.initials: CS
authors.lastname: Lin
authors.affiliation: Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan, R.O.C.
authors.forename: Giia-Sheun
authors.initials: GS
authors.lastname: Peng
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan, R.O.C.
authors.forename: Ping-Ying
authors.initials: PY
authors.lastname: Chang
keywords: diffuse large B-cell lymphoma; oculomotor nerve palsy; paraneoplastic