Abstract
The authors report a case of malignant lymphoma presenting with clinical signs of Tolosa-Hunt Syndrome (THS) and pain in the ipsilateral upper limb. A 69-year-old male complained of acute pain in the left V1 and V2 trigeminal territories, left ptosis, and pain in the left upper limb. Magnetic resonance imaging (MRI) showed abnormal mass in the region of cavernous sinus and deformity of the cervical vertebra. We diagnosed his status as Tolosa-Hunt syndrome complicated by cervical spondylosis, and thus initiated steroid therapy and stellate ganglion block. The patient's symptoms however did not improve; furthermore, lower cranial nerve disorder appeared and enlargement of abnormal mass in the region of cavernous sinus was noted. Cranial biopsy for clearer diagnosis showed malignant lymphoma. The patient was placed on radiotherapy and chemotherapy, which resulted in an improvement of the symptoms. It is important to discriminate other diseases including malignant lymphoma patients showing THS-like symptoms especially when the patient has progressive symptoms other than ophthalmoplegia and pain in the V1 trigeminal territory.
