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Abstract

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Article in Japanese

Case Report

A case of squamous cell lung cancer presenting as orbital apex syndrome due to metastasis of the right greater wing of sphenoid bone

Shingo Nakayama  Eri Iwami  Shinnosuke Ikemura  Takahiro Nakajima  Tatsu Matsuzaki  Takeshi Terashima 

Department of Respiratory Medicine, Tokyo Dental College Ichikawa General Hospital

ABSTRACT

It is well known that bone metastases from lung cancer are quite common. However, it is rare that metastases to the orbital bone (such as sphenoid bone) from lung cancer cause cranial nerve symptoms. An 80-year-old man was diagnosed as squamous cell lung cancer (cT2N3M0 stage IIIB) and treated with radical chemoradiotherapy. After a year and a half, the patient presented with visual impairment and nasal hemianopsia of the right eye. The CT scan and MRI showed destruction of the greater wing of the right sphenoid bone and involvement of the optic canal and superior orbital fissure. The patient was diagnosed as orbital apex syndrome with visual loss, dysfunction of right ocular movement, and progression of cranial nerve disorders. Palliative radiation therapy induced the attenuation of right facial pain, but not the improvement of cranial nerve symptoms. When impairment of visual acuity and field are observed during the clinical course of lung cancer, it is important to consider the possibility of metastases as the cause and to initiate exanimations and adequate therapy.

KEYWORDS

Lung cancer  Bone metastasis  Greater wing of sphenoid bone  Orbital apex syndrome 

Received 6 Jan 2017 / Accepted 13 Mar 2017

AJRS, 6(4): 270-273, 2017

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