Isolated sixth cranial nerve palsy as the presenting symptom of a rapidly expanding ACTH positive pituitary adenoma: a case report

BMC Ophthalmology

Case Report

Benjamin Rubin¹  Jafar Jafar¹  Alice Kim²  Norman Saffra³  Irina Mikolaenko⁴  Elizabeth Kaplow⁵ 

[1] Department of Neurosurgery, New York University Langone Medical Center, New York, NY, USA;Department of Ophthalmology, Maimonides Medical Centerm, Brooklyn, New York, USA;Department of Ophthalmology, Mount Sinai School of Medicine, New York, NY, USA;Department of Ophthalmology, Maimonides Medical Centerm, Brooklyn, New York, USA;Department of Pathology, Division of Neuropathology, New York University, New York, NY, USA;Mount Sinai School of Medicine, New York, NY, USA;

关键词: Sarcoidosis;    Pituitary Adenoma;    Cavernous Sinus;    Sixth Cranial Nerve;    Pituitary Apoplexy;   

DOI  :  10.1186/1471-2415-11-4

 received in 2010-10-27, accepted in 2011-01-27,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundPituitary adenoma may present with neuro-ophthalmic manifestations and, typically, rapid tumor expansion is the result of apoplexy. Herein, we present the first case of an isolated sixth cranial nerve palsy as initial feature of a rapidly expanding ACTH positive silent tumor without apoplexy.Case PresentationA 44 year old female with a history of sarcoidosis presented with an isolated sixth cranial nerve palsy as the initial clinical feature of a rapidly expanding ACTH positive silent pituitary adenoma. The patient underwent emergent transsphenoidal hypophysectomy for this rapidly progressive tumor and subsequently regained complete vision and ocular motility. Despite tumor extension into the cavernous sinus, the other cranial nerves were spared during the initial presentation.ConclusionsThis case illustrates the need to consider a rapidly growing pituitary tumor as a possibility when presented with a rapidly progressive ophthalmoplegia.

【 授权许可】

Unknown   
© Saffra et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.