Korean J Otorhinolaryngol-Head Neck Surg.  2014 Sep;57(9):626-629. 10.3342/kjorl-hns.2014.57.9.626.

A Case of Pituitary Metastasis of Lung Cancer Presenting as Cavernous Sinus Syndrome

• Lee JJ
• Lee SH
• Cho B
• Kim K

• KMID: 1726632
• DOI: http://doi.org/10.3342/kjorl-hns.2014.57.9.626

Abstract

The cavernous sinus contains significant structures such as the internal carotid artery and cranial nerves III to VI. Cavernous sinus lesions may cause ophthalmoplegia, proptosis, and diplopia. We report a 56-year-old woman who presented with throbbing headache and associated right-sided ocular pain. While awaiting imaging studies, she suddenly developed opthalmoplegia and ptosis of the right eye. She had ipsilateral palsy of the third and fourth cranial nerves, while the sixth nerve remained intact. Magnetic resonance imaging revealed a pituitary gland mass extending into the right cavernous sinus with associated sphenoid sinusitis. The patient underwent endoscopic sinus surgery and subsequent pituitary tumor removal by transsphenoidal approach. During preoperative evaluation, a mass was found protruding in her left bronchus. The pituitary tumor pathologic examination revealed metastatic adenocarcinoma of the lung. In this patient, the initial symptoms of lung cancer were headache and cavernous sinus syndrome, which had metastasized to the pituitary gland.

Keyword

Adenocarcinoma of the lung; Cavernous sinus syndrome; Metastasis; Pituitary gland; Sphenoid sinusitis

MeSH Terms

Adenocarcinoma
Bronchi
Carotid Artery, Internal
Cavernous Sinus*
Cranial Nerves
Diplopia
Exophthalmos
Female
Headache
Humans
Lung
Lung Neoplasms*
Magnetic Resonance Imaging
Middle Aged
Neoplasm Metastasis*
Ophthalmoplegia
Paralysis
Pituitary Gland
Pituitary Neoplasms
Sphenoid Sinus
Sphenoid Sinusitis
Trochlear Nerve