A 46-year-old man presented with a 3-month history of horizontal diplopia. He also reported chronic left nasal obstruction. Ophthalmological examination revealed a complete left abduction deficit (Figure 1A). CT-Scan, revealed a left nasopharynx mass (Figure 1B). Upon nasofibroscopy, we found an ulcerated and bleeding mass in the left nasopharynx. Biopsy of this mass confirmed the diagnosis of Undifferentiated Carcinoma of Nasopharyngeal Type.
Nasopharyngeal carcinoma is widespread in Southeast Asia and North Africa and less prevalent in Europe and America. Its main symptoms are rhinological signs such as nasal obstruction and epistaxis, or the presence of cervical lymph nodes. Neurological signs are rare. Sixth nerve palsy is the most frequent form of oculomotor nerve palsy in adults. Its main etiologies are microvascular ischemia and trauma. However, other less well-known causes can be found, such as meningitis, stroke, intracranial hypertension, giant cell arteritis and tumors.
FundingThis research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Patient consentA written consent to publish this case report has been obtained from the patient.
