Isolated oculomotor nerve palsy as a manifestation of diffuse large B cell lymphoma: A case report

Khaleefah,Muntadher M.; Narayanan,Siddharth; Al Dallal,Hiba A.; Jones,Christopher M.; Friedland,Robert P.; Palade,Adriana E.; Remmel,Kerri S.; Shah,Jignesh J.

doi:10.3892/ol.2020.12147

Isolated oculomotor nerve palsy as a manifestation of diffuse large B cell lymphoma: A case report

Authors:
- Muntadher M. Khaleefah
- Siddharth Narayanan
- Hiba A. Al Dallal
- Christopher M. Jones
- Robert P. Friedland
- Adriana E. Palade
- Kerri S. Remmel
- Jignesh J. Shah
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Affiliations: Department of Neurology, University of Louisville Hospital, University of Louisville, Louisville, KY 40202, USA, Department of Surgery, University of Louisville Hospital, University of Louisville, Louisville, KY 40202, USA, Department of Pathology and Laboratory Medicine, University of Louisville Hospital, University of Louisville, Louisville, KY 40202, USA
Published online on: September 23, 2020 https://doi.org/10.3892/ol.2020.12147
Article Number: 285
Copyright: © Khaleefah et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

An isolated third nerve palsy presenting as the primary manifestation of a lymphoma is rare, with only few cases having been described. The present study reports an unusual case of a healthy 67‑year old male diagnosed with isolated right oculomotor nerve palsy (ONP), who was found to have an underlying B cell lymphoma. The patient's medical records were accessed upon consent. A thorough physical examination, including stroke and infections work‑ups were performed. A chest computerized tomography (CT), brain magnetic resonance imaging and positron emission tomography (PET) scans and a mediastinal tissue biopsy, were performed as part of systematic diagnostic evaluations. The current report suggests that a PET fluorodeoxyglucose study or a CT scan of the chest, abdomen and pelvis (with contrast) may help in the early diagnosis of a cancer responsible for ONP, particularly if brain vessel imaging does not show a posterior cerebral artery aneurysm as a cause for the defect.

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