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Journal of Medical Case Reports

, 2:194

First Online: 05 June 2008Received: 28 December 2007Accepted: 05 June 2008DOI: 10.1186-1752-1947-2-194

Cite this article as: Masoud, M.T., Rehman, A. & Shaikh, Y. J Med Case Reports 2008 2: 194. doi:10.1186-1752-1947-2-194

Abstract

IntroductionAbduction deficit in the elderly is commonly caused by sixth cranial nerve palsy due to microvasculopathy. However, not all such cases are of neurogenic origin, as our case report shows.

Case presentationWe present the case of a 75-year-old woman who was generally unwell, developed acute diplopia and was found to have a right abduction deficit in a quiet eye with no gross orbital signs and symptoms. A computed tomography scan of the head and orbits revealed a metastatic mass in the right lateral rectus muscle. Systemic evaluation confirmed widespread thoracic and abdominal metastases from an occult systemic malignancy. Lateral rectus metastasis from an occult systemic malignancy was masquerading as abducens palsy.

ConclusionOrbital metastasis involving extraocular muscles can present as isolated diplopia with minimal local signs and the absence of a history of systemic malignancy. A detailed history and systemic examination can identify suspicious cases, which should be investigated further. The clinician should avoid presuming that such an abduction deficit in the elderly is a benign neurogenic palsy.

AbbreviationsCTcomputed tomography

ESRerythrocyte sedimentation rate

GCAgiant cell arteritis

MRImagnetic resonance imaging.

Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-2-194 contains supplementary material, which is available to authorized users.

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Autor: Mohammad T Masoud - Ajmal Rehman - Yusuf Shaikh

Fuente: https://link.springer.com/



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