Korean J Otolaryngol-Head Neck Surg.  2006 Nov;49(11):1113-1117.

A Case of B-Cell Lymphoma of Sphenoid Sinus Invading Cavernous Sinus and Middle Cranial Fossa

• Koo HJ
• Kim TW
• Cho KS
• Roh HJ

Abstract

We report on an unusual case of primary extranodal non-Hodgkin's lymphoma of the sphenoid sinus invading cavernous sinus. A 69-year-old male patient presented with left facial pain and headache. A nasal endoscopy revealed no specific finding in both nasal cavity and no definite mass like lesion was found in the nasal cavity. Paranasal CT scans demonstrated mild haziness without bony erosion or thinning in left sphenoid sinus. Several months later, he complained of a ptosis and lateral gaze palsy of the left eye when he gazed at the left side. Brain MRI showed a well enhanced lobulated mass in the left sphenoid sinus invading into the left carvenous sinus and middle cranial fossa with left internal carotid artery encasement. Endoscopic biopsy via transnasal sphenoidotomy was performed under general anesthesia, and an easy fragile, yellowish, reddish mass in the sphenoid sinus was partially removed. The mass had infiltrated into the lateral, inferior and superior wall of the left sphenoid sinus. Biopsy confirmed a diffused large B-cell lymphoma. First, the patient received gamma knife radiosurgery, followed by chemotherapy (rituximab, cyclophosphamide, adriamycin, vincristine, prednisolone). He has been in complete remission state for eight months after combination therapy.

Keyword

Lymphoma; Sphenoid sinus; Cavernous sinus; Middle cranial fossa; Radiosurgery

MeSH Terms

Aged
Anesthesia, General
B-Lymphocytes*
Biopsy
Brain
Carotid Artery, Internal
Cavernous Sinus*
Cranial Fossa, Middle*
Cyclophosphamide
Doxorubicin
Drug Therapy
Endoscopy
Facial Pain
Headache
Humans
Lymphoma
Lymphoma, B-Cell*
Lymphoma, Non-Hodgkin
Magnetic Resonance Imaging
Male
Nasal Cavity
Paralysis
Radiosurgery
Sphenoid Sinus*
Tomography, X-Ray Computed
Vincristine
Cyclophosphamide
Doxorubicin
Vincristine