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Alveolar rhabdomyosarcoma of the sphenoid sinus mimicking optic neuritis presenting with intermittent visual loss in an adult

Authors Liu W, Jiang L, Jin Y, Yang BT, Lai TYY

Received 21 February 2016

Accepted for publication 10 June 2016

Published 14 October 2016 Volume 2016:9 Pages 6333—6336


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Chang Liu

Peer reviewer comments 3

Editor who approved publication: Professor Min Li

Wendong Liu,1 Libin Jiang,1 Yulan Jin,2 Bentao Yang,3 Timothy YY Lai4

1Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, 2Department of Pathology, 3Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 4Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong, People’s Republic of China

A 23-year-old male with intermittent visual loss in his left eye for 4 months was originally treated as optic neuritis elsewhere. Upon presentation to our hospital (Beijing Tongren Hospital), his left eye visual acuity was reduced to hand motion at face. The left eye ocular motility was limited in upgaze, downgaze, adduction, and abduction. Computed tomography and magnetic resonance imaging revealed lesions in the sphenoid and ethmoid sinuses, orbital apex and carvernous sinus invading adjacent extraocular muscles. Endoscopic ethmo-sphenoidostomy and debulking surgery was performed and histopathology of the specimen demonstrated alveolar rhabdomyosarcoma. Despite having treatment with a combination of orbital radiation therapy and systemic chemotherapy, the patient developed generalized metastasis with cachexia and the left eye became no light perception due to optic atrophy.

Keywords: alveolar rhabdomyosarcoma, sphenoid sinus, optic neuritis, misdiagnosis

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