You are here

Article Text

Article menu
Download PDFPDF
Unusual association of diseases/symptoms
CASE REPORT
Diplopia: a unique presentation of recurrence of a salivary gland carcinoma
  1. David Mackinlay1,
  2. Aaron Stephen James Ferguson1,
  3. Sharon White2 and
  4. Jaiganesh Manickavasagam1,3
  1. 1 Department of Otorhinolaryngology, Ninewells Hospital, Dundee, UK
  2. 2 School of Dentistry, University of Dundee, Dundee, UK
  3. 3 Tayside Medical Science Centre, University of Dundee, Dundee, UK
  1. Correspondence to Jaiganesh Manickavasagam, jaiganesh.manickavasagam{at}nhs.net

Abstract

A 79-year-old man with a history of radical excision of a left submandibular gland carcinoma ex-pleomorphic adenoma presented with a new 2 cm lump in his left submandibular region which proved to be recurrence on surgical excision. During work up for revision surgery he developed a right VI cranial nerve palsy, which was attributed to his microvascular status having had a history of three previous transient ischemic attacks (TIAs). 6 months later, his palsy had not resolved. MRI revealed new soft tissue by the cavernous segment of the internal carotid artery. The exact source of this was unclear as there was no evidence of local recurrence or nodal disease. A repeat MRI scan 16 months later revealed further growth of abnormal tissue in the cavernous sinus and the primary submandibular location, now involving multiple nerves including branches of cranial nerves IV, V, VI, VII and XII making surgical excision impossible.

  • ear, nose and throat/otolaryngology
  • head and neck cancer
  • radiology
  • ophthalmology
  • pathology

https://doi.org/10.1136/bcr-2018-225243

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors DM analysed the case with case notes, investigations and drafted the case report. ASJF helped with analysis, drafting, interpretation and revisions of the report. SW contributed expert opinion and revisions with specific histopathology scope. JM contributed conception of design of report, revision and final approval of version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.