Unilateral Sixth Nerve Palsy Unveiling a Giant Nasopharyngeal Tumor: A Rare Case of Neuro Ophthalmic Presentation

S. Sadiki *

Department of Ophtalmology, Military hospital Mohamed V, Rabat, Morocco.

K. Sifnasr

Department of Radiology, Military hospital Mohamed V, Rabat, Morocco.

I. Tazi

Department of Anatomic Pathology, Military hospital Mohamed V, Rabat, Morocco.

S. Sebbata

Department of Ophtalmology, Military hospital Mohamed V, Rabat, Morocco.

Y. Achegri

Department of Ophtalmology, Military hospital Mohamed V, Rabat, Morocco.

S. Salama

Department of Ophtalmology, Military hospital Mohamed V, Rabat, Morocco.

A. Fiqhi

Department of Ophtalmology, Military hospital Mohamed V, Rabat, Morocco.

Y. Mouzari

Department of Ophtalmology, Military hospital Mohamed V, Rabat, Morocco.

A. Oubaaz

Department of Ophtalmology, Military hospital Mohamed V, Rabat, Morocco.

*Author to whom correspondence should be addressed.


Abstract

Nasopharyngeal tumor is an intrusive tumor arising from the epithelium of the nasopharynx, presenting as different symptoms depending on the area of the development of the tumor. It is an endemic carcinoma in North Africa. The location of the tumor, its difficult access to the physical examination and the symptomatology often misleading associated with invasion of adjacent structures explain the often delayed diagnosis.

The purpose is to report a rare neuro-ophthalmic presentation of nasopharyngeal carcinoma.

We report the case of a 60 years old woman who first presented with a sixth nerve palsy leading to the diagnosis of a giant nasopharyngeal tumor extending to the cavernous sinus.

Keywords: Nasopharyngeal tumor, abducens, diplopia, cavernous sinus


How to Cite

Sadiki , S., Sifnasr , K., Tazi , I., Sebbata , S., Achegri , Y., Salama, S., Fiqhi , A., Mouzari , Y., & Oubaaz , A. (2024). Unilateral Sixth Nerve Palsy Unveiling a Giant Nasopharyngeal Tumor: A Rare Case of Neuro Ophthalmic Presentation. Asian Journal of Research and Reports in Ophthalmology, 7(1), 107–112. Retrieved from https://journalajrrop.com/index.php/AJRROP/article/view/106

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References

Agrawal A, Baisakhiya NV Sj, J Sr. Nasopharyngeal Carcinoma Presenting with Cavernous Sinus Involvement. Trigeminal Neuralgia and Middle Ear Effusion; 2009.

Lekskul A, Thanomteeranant S, Tangtammaruk P, Wuthisiri W. Isolated sixth nerve palsy as a first presentation of nasopharyngeal carcinoma: A case series. Int Med Case Rep J. 2021;14:801– 808.

DOI: 10.2147/IMCRJ.S334476

Hernandy Yuliawan H, Kartika A, Hanindya Sari R. Abducens nerve palsy as the first manifestation of nasopharyngeal malignancy.

Chow JCH et al. Cranial neuropathies in advanced nasopharyngeal carcinoma: Neurological recovery after modern radiotherapy and systemic chemotherapy. Radiotherapy and Oncology. Oct. 2021; 163:221– 228. DOI: 10.1016/j.radonc.2021.08.022

Kau HC, Tsai CC. New onset diplopia in patients with nasopharyngeal carcinoma following concurrent chemoradiotherapy: Clinical features and etiology. Biomed Res Int. 2015;2015. DOI: 10.1155/2015/735173.

Aghdam KA Zand A, Sanjari MS. Isolated unilateral sixth nerve palsy in a patient with nasopharyngeal carcinoma. Rom J Ophthalmol. Dec. 2019; 63(4):375– 378.

DOI: 10.22336/rjo.2019.59

Leung SF, Tsao SY, Teo P, Foo W. Clinical oncology original article cranial nerve involvement by nasopharyngeal carcinoma: Response to treatment and clinical significance; 1990.

Gupta R, Mohindroo NK, Azad R. Nasopharyngeal carcinoma with an uncommon presentation. Int J Head Neck Surg. 2017;8(1):34-36.

Wendy Meihua Wong, Stephanie Ming Young, Shantha Amrith: Ophthalmic involvement in nasopharyngeal carcinoma, Orbit; 2017.

Liao J-F, Ma L, Du X-J, Lan M, Guo Y, Zheng L, et al. Prognostic Value of Cavernous ; 2016.

Sinus invasion in patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy. PLoS One. 2016; 11(1): e0146787. DOI: 10.1371/journal.pone.0146787

Ding JH, Hu CS, Peng WJ, Zhou ZR, Tang F, Mao J. Evaluation of MRI in nasopharyngeal carcinoma with cavernous sinus infiltration. Zhonghua Zhong Liu Za Zhi. 2006;28:530–2.

PMID: 17147120

Patel SV, Mutyala S, Leske DA, Hodge DO, Holmes JM. Incidence, associations, and evaluation of sixth nerve palsy using a population-based method. Ophthalmology 2004;111(2):369–75. Available:https://doi.org/10.1016/j.ophtha.2003.05.024

Marlinda Adham., et al. Delayed diagnosis of nasopharyngeal carcinoma in a patient with early signs of unilateral ear disorder. Medical Journal of Indonesia. 23.1 2014:52-57.

Aghdam KA, Zand A, Sanjari MS. Isolated unilateral sixth nerve palsy in a patient with nasopharyngeal carcinoma. Rom J Ophthalmol. 2019; 63(4):375–8 Available:https://doi.org/10.22336/rjo.2019.59.