Metastatic pancreatic carcinoma to the orbital apex presenting as a superior divisional third cranial nerve palsy

Paula E Pecen,1 Nicholas A Ramey,1 Michael J Richard,1 M Tariq Bhatti1,21Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA; 2Department of Medicine (Division of Neurology), Duke University Medical Center, Durham, NC, USAAbstract: Metastatic tumors to the orbit are rare, especi...

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Autores principales:	Bhatti MT, Richard MJ, Ramey NA, Pecen PE
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/3de561b4e0e8477baf78f904ded28317
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spelling	oai:doaj.org-article:3de561b4e0e8477baf78f904ded283172021-12-02T01:32:04ZMetastatic pancreatic carcinoma to the orbital apex presenting as a superior divisional third cranial nerve palsy1177-54671177-5483https://doaj.org/article/3de561b4e0e8477baf78f904ded283172012-11-01T00:00:00Zhttp://www.dovepress.com/metastatic-pancreatic-carcinoma-to-the-orbital-apex-presenting-as-a-su-a11590https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Paula E Pecen,1 Nicholas A Ramey,1 Michael J Richard,1 M Tariq Bhatti1,21Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA; 2Department of Medicine (Division of Neurology), Duke University Medical Center, Durham, NC, USAAbstract: Metastatic tumors to the orbit are rare, especially from a primary pancreatic carcinoma. A 59-year-old man presented with 4 weeks of right eye pain and eyelid swelling. There was right upper eyelid ptosis associated with a right supraduction deficit consistent with a superior divisional third cranial nerve (CN III) palsy. Magnetic resonance imaging revealed a right orbital apex lesion. A right orbital exenteration was performed for intractable and severe pain. Surgical pathology demonstrated a poorly differentiated carcinoma that was ultimately felt to be derived from the pancreas. In this report, we describe the clinical and neurological imaging findings of a superior divisional CN III palsy as the presenting manifestation of a presumed metastatic pancreatic carcinoma to the orbital apex, and review the neuroanatomy of CN III with particular emphasis on the anatomical bifurcation of the nerve into a superior and inferior division.Keywords: orbital tumor, orbital metastasis, superior division, third cranial nerve palsyBhatti MTRichard MJRamey NAPecen PEDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2012, Iss default, Pp 1941-1943 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Bhatti MT Richard MJ Ramey NA Pecen PE Metastatic pancreatic carcinoma to the orbital apex presenting as a superior divisional third cranial nerve palsy
description	Paula E Pecen,1 Nicholas A Ramey,1 Michael J Richard,1 M Tariq Bhatti1,21Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA; 2Department of Medicine (Division of Neurology), Duke University Medical Center, Durham, NC, USAAbstract: Metastatic tumors to the orbit are rare, especially from a primary pancreatic carcinoma. A 59-year-old man presented with 4 weeks of right eye pain and eyelid swelling. There was right upper eyelid ptosis associated with a right supraduction deficit consistent with a superior divisional third cranial nerve (CN III) palsy. Magnetic resonance imaging revealed a right orbital apex lesion. A right orbital exenteration was performed for intractable and severe pain. Surgical pathology demonstrated a poorly differentiated carcinoma that was ultimately felt to be derived from the pancreas. In this report, we describe the clinical and neurological imaging findings of a superior divisional CN III palsy as the presenting manifestation of a presumed metastatic pancreatic carcinoma to the orbital apex, and review the neuroanatomy of CN III with particular emphasis on the anatomical bifurcation of the nerve into a superior and inferior division.Keywords: orbital tumor, orbital metastasis, superior division, third cranial nerve palsy
format	article
author	Bhatti MT Richard MJ Ramey NA Pecen PE
author_facet	Bhatti MT Richard MJ Ramey NA Pecen PE
author_sort	Bhatti MT
title	Metastatic pancreatic carcinoma to the orbital apex presenting as a superior divisional third cranial nerve palsy
title_short	Metastatic pancreatic carcinoma to the orbital apex presenting as a superior divisional third cranial nerve palsy
title_full	Metastatic pancreatic carcinoma to the orbital apex presenting as a superior divisional third cranial nerve palsy
title_fullStr	Metastatic pancreatic carcinoma to the orbital apex presenting as a superior divisional third cranial nerve palsy
title_full_unstemmed	Metastatic pancreatic carcinoma to the orbital apex presenting as a superior divisional third cranial nerve palsy
title_sort	metastatic pancreatic carcinoma to the orbital apex presenting as a superior divisional third cranial nerve palsy
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/3de561b4e0e8477baf78f904ded28317
work_keys_str_mv	AT bhattimt metastaticpancreaticcarcinomatotheorbitalapexpresentingasasuperiordivisionalthirdcranialnervepalsy AT richardmj metastaticpancreaticcarcinomatotheorbitalapexpresentingasasuperiordivisionalthirdcranialnervepalsy AT rameyna metastaticpancreaticcarcinomatotheorbitalapexpresentingasasuperiordivisionalthirdcranialnervepalsy AT pecenpe metastaticpancreaticcarcinomatotheorbitalapexpresentingasasuperiordivisionalthirdcranialnervepalsy
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Metastatic pancreatic carcinoma to the orbital apex presenting as a superior divisional third cranial nerve palsy

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