副鼻腔がんに続発する圧縮性視神経障害に対するコルチコステロイド治療後の良好な視覚的転帰

Good Visual Outcome Following Corticosteroid Treatment for Compressive Optic Neuropathy Secondary to Sinonasal Carcinoma.

• Amirah Mohammad Razali
• Ayesha Mohd Zain
• Wan Haslina Bt Wan Abdul Halim
• Norshamsiah Md Din

抄録

副鼻腔がん患者のほとんどは鼻の症状を伴って耳鼻咽喉科を受診する。しかし、初診時に急性視力低下を呈することはまれである。副鼻腔癌に続発した圧迫性視神経症を呈し、起床時に右眼のぼやけを急性に呈した1例を報告する。病理組織学的検査では扁平上皮副鼻腔癌と診断された．視力はメチルプレドニゾロン1日1gを3日間パルス静注した後、経口プレドニゾロン（1mg/kg/日）を漸減投与することで改善した。

Most patients with sinonasal carcinoma present to the otorhinolaryngologist with nasal symptoms. It is however uncommon for them to present with acute visual loss at first presentation. We report a case of compressive optic neuropathy secondary to sinonasal carcinoma, which presented acutely with right eye blurring of vision upon waking up. Computed tomography (CT) of the brain and orbit with contrast showed a locally invasive nasopharyngeal mass extending into the right orbit and cranial fossa. Histopathological examination revealed squamous cell sinonasal carcinoma. Her visual acuity improved with a three-day course of pulsed intravenous methylprednisolone 1 g per day, followed by a gradual tapering dose of oral prednisolone (1 mg/kg/day).

Copyright © 2020, Mohammad Razali et al.