A Patient with Isolated Sixth Nerve Palsy as the Only Presenting Sign of Prostate Cancer Metastasis
Kiana Hassanpour1 *, Iman Ansari2 , Faezeh Khorasani Zadeh3
- Ophthalmic Research Center, Research institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Kiana Hassanpour
- Department of Radiology, Razi Hospital, Tehran University of Medical University, Tehran, Iran
Abstract: A 72-year-old man complaining of sudden-onset diplopia in the right eye presented to our ophthalmology department.
Methods: He noticed the previous history of prostate cancer and was tumor-free for 10 years. The diplopia was binocular, worse in distance. The ocular movement of the right eye showed moderate limitation in the right gaze. The examination of all other cranial nerves was normal.
Results: The patient underwent neuroimaging with the diagnosis of isolated cranial nerve (CN) VI palsy which revealed abnormal bone marrow signal and expansion of clivus, sphenoid, and an orbital plate of frontal bone at the right orbital roof. The patient underwent a bone scan that confirmed generalized bone metastasis.
Conclusion: We presented a 72-year-old man with isolated CN VI palsy as the only presenting sign of bone metastasis secondary to prostate cancer. Systemic cancer history is an important risk factor that should not be overlooked in patients with isolated CN VI palsy nerve palsy.
