Case report

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

Young Mok Park¹ , Jun Hyung Cho¹ , Jae Yong Cho² , Ji Soon Huh³ and Jung Yong Ahn¹

¹Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea

²Department of Medical Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea

³Department of Neurosurgery, College of Medicine, Cheju National University Hospital, Jeju, Republic of Korea

author email corresponding author email

World Journal of Surgical Oncology 2007, 5:86doi:10.1186/1477-7819-5-86

Published:	3 August 2007

Abstract

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.

Case presentation

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.

Conclusion

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.