Lateral rectus metastasis from an occult systemic malignancy masquerading as abducens palsy: a case report

Masoud, Mohammad T; Rehman, Ajmal; Shaikh, Yusuf

doi:10.1186/1752-1947-2-194

Cited by 5 publications

(2 citation statements)

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“…Die Abduzensparese kann auch durch Orbitatumoren verursacht werden, obgleich hier meist der Exophthalmus im Vordergrund steht. Verwiesen sei auf den Einzelfallbericht einer CUP-Metastase im M. rectus lateralis, die als Abduzensparese in Erscheinung trat [21].…”

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Abduzensparese mit Ursache im HNO-Fachgebiet

2017

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Patients suffering from abducent nerve palsy are usually primary seen by a conservative medical Specialist. In most cases the ENT specialist is secondary involved for treatment. In the majority of cases abducent nerve palsy is a temporary symptom associated with neurologic or vascular diseases. Rarely inflammation, neoplasm or fracture of the skull base cause this symptom and lead to an intervention done by the ENT surgeon. This case series describes retrospectively the abducent palsy seen through the eyes of an ENT surgeon. From 2008 to 2011 15 patients suffering from abducent nerve palsy. One patient suffering from a temporal bone fracture has been treated conservatively while 14 patients needed surgery. 6 patients had a complicated inflammation of the skull base. In 7 patients skull base neoplasms were found in endoscopic surgery. In one case the underlying pathology remained unclear. 2 third of the patients that suffered from complications of inflammatory diseases completely recovered after a combined operative and conservative therapy. The patients who suffered from neoplasms of the skull base partially recovered in only one third, none, achieved full recovery. The patient with the temporal bone fracture achieved a partial recovery after 3 months. If the leading symptom of abducent palsy is caused by a severe extracranial inflammation, neoplasm or trauma an experienced skull base surgeon is mandatory. The recovery rate of abducent palsy in our case series was 60 %. The prognosis of abducent palsy in skull base inflammation is much better compared to patients with skull base neoplasm.

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Abduzensparese mit Ursache im HNO-Fachgebiet

2017

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“…When older patients present with abduction deficit along with systemic symptoms, generalized weakness and weight loss, the possibility of malignancy must be ruled out. [ 7 ] Nair et al . have reported that 6.3% of cases of sixth nerve palsy are due to undiagnosed tumors.…”

Section: Discussionmentioning

confidence: 99%

Abduction Deficit Mimicking Sixth Nerve Palsy due to Metastasis in Systemic Malignancy

Parija

Sen

2021

Middle East African Journal of Ophthalmology

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Lateral rectus palsy presenting as abduction deficit resulting in diplopia is attributed to neurogenic causes. Metastasis as a cause of sixth cranial palsy is an extremely rare entity but cannot be overlooked. Cases of metastasis to lateral rectus secondary to lung and breast carcinoma have been reported. Primary adrenocortical carcinoma (ACC) metastasizing to lateral rectus muscle is extremely rare. Here, we report a case of ACC arising from the left adrenal gland that presented with left-sided abduction deficit in a 58-year-old male with vasculopathic risk factors. The case highlights the importance of neuroimaging in cases of isolated nontraumatic sixth nerve palsy or in cases with isolated ocular symptoms with associated systemic findings. The fact that all cases of muscle palsies may not be neurogenic and rare causes such as metastatic muscle involvement must be included as a differential diagnosis in suspected cases has been emphasized.

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