Survey of Ophthalmology
Volume 55, Issue 6 , Pages 590-597, November 2010

The Bell's Toll

  • Luciano Mesquita Simão, MD

      Affiliations

    • Department of Ophthalmology and Otolaryngology, Federal University of Minas Gerais, Brazil
    • ,
  • Ann P. Murchison, MD, MPH

      Affiliations

    • Oculoplastic and Orbital Surgery Service, Wills Eye Institute, Philadelphia, Pennsylvania, USA
    • Corresponding Author InformationReprint address: Dr. Ann P. Murchison, Oculoplastic and Orbital Surgery Service, Suite 910, Wills Eye Institute, 840 Walnut Street, Philadelphia, PA 19107.
    • ,
  • Jurij R. Bilyk, MD

      Affiliations

    • Oculoplastic and Orbital Surgery Service, Wills Eye Institute, Philadelphia, Pennsylvania, USA
    • ,
  • Peter A.D. Rubin, MD

      Affiliations

    • Ophthalmic Plastics and Orbital Surgery, West Palm Beach , Florida, USA
    • Eye Plastics Consultants, Brookline, Massachusetts, USA

published online 10 May 2010.

Peter Savino and Helen Danesh-Meyer, Editors

Abstract 

A 70-year-old man presented complaining of lid and facial drooping and facial numbness, which progressed over several months. Magnetic resonance imaging of the head showed an enlarged right cavernous sinus. His past medical history was remarkable to squamous cell carcinoma of the face. The patient underwent a craniotomy with biopsy of the cavernous sinus that confirmed malignancy. High index of suspicion in a patient that presents facial drooping and/or numbness should alert ophthalmologists about the occurrence of perineural spread of a previous malignant lesion of the skin.

Key words: cavernous sinus syndrome, external ophthalmoplegia, facial numbness, facial palsy, perineural spread, squamous cell carcinoma

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 The authors reported no proprietary or commercial interest in any product mentioned or concept discussed in this article.

PII: S0039-6257(09)00315-4

doi:10.1016/j.survophthal.2009.12.004

Survey of Ophthalmology
Volume 55, Issue 6 , Pages 590-597, November 2010

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