Acute visual loss in a head and neck cancer patient with ocular metastasis and sphenoid pyocele

Auris Nasus Larynx. 2007 Dec;34(4):569-71. doi: 10.1016/j.anl.2007.02.008. Epub 2007 May 8.

Abstract

We report an extremely rare case of head and neck cancer patient with right acute visual loss by ocular metastasis after excluding compressive optic neuropathy by endoscopic decompression of the sphenoid pyocele. The ocular metastasis from head and neck cancer had been reported only once in English literatures. Besides, the patient combined with sphenoid pyocele increases the difficulty in differentiating the etiologies. In this article, we describe the history of this patient and discuss the possible cause of acute visual loss and the treatment strategy. Although to differentiate the etiology of acute visual loss between metastatic malignancy and compressive optic neuropathy remain difficult, treatment strategy should focus on rescuing visual acuity. Ocular metastases should always keep in mind when acute visual loss is encountered in patients with previously treated head and neck squamous cell carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Abscess / diagnosis
  • Abscess / etiology*
  • Abscess / surgery
  • Blindness / etiology*
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / secondary*
  • Carcinoma, Squamous Cell / surgery
  • Carcinoma, Verrucous / diagnosis
  • Carcinoma, Verrucous / radiotherapy
  • Carcinoma, Verrucous / secondary*
  • Carcinoma, Verrucous / surgery
  • Choroid Neoplasms / diagnosis
  • Choroid Neoplasms / radiotherapy
  • Choroid Neoplasms / secondary*
  • Decompression, Surgical
  • Diagnosis, Differential
  • Endoscopy
  • Humans
  • Laryngeal Neoplasms / diagnosis
  • Laryngeal Neoplasms / surgery
  • Laryngectomy
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Mouth Neoplasms / diagnosis
  • Mouth Neoplasms / surgery
  • Neoplasms, Multiple Primary / diagnosis
  • Neoplasms, Multiple Primary / surgery*
  • Nerve Compression Syndromes / diagnosis
  • Nerve Compression Syndromes / etiology
  • Nerve Compression Syndromes / surgery
  • Ophthalmoscopy
  • Optic Nerve Diseases / diagnosis
  • Optic Nerve Diseases / etiology
  • Optic Nerve Diseases / surgery
  • Otorhinolaryngologic Neoplasms / diagnosis
  • Otorhinolaryngologic Neoplasms / surgery*
  • Palliative Care
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology*
  • Postoperative Complications / radiotherapy
  • Reoperation
  • Sphenoid Sinusitis / diagnosis
  • Sphenoid Sinusitis / etiology*
  • Sphenoid Sinusitis / surgery