Metastatic pancreatic carcinoma to the orbital apex presenting as a superior divisional third cranial nerve palsy.

Journal Article

Metastatic tumors to the orbit are rare, especially from a primary pancreatic carcinoma. A 59-year-old man presented with 4 weeks of right eye pain and eyelid swelling. There was right upper eyelid ptosis associated with a right supraduction deficit consistent with a superior divisional third cranial nerve (CN III) palsy. Magnetic resonance imaging revealed a right orbital apex lesion. A right orbital exenteration was performed for intractable and severe pain. Surgical pathology demonstrated a poorly differentiated carcinoma that was ultimately felt to be derived from the pancreas. In this report, we describe the clinical and neurological imaging findings of a superior divisional CN III palsy as the presenting manifestation of a presumed metastatic pancreatic carcinoma to the orbital apex, and review the neuroanatomy of CN III with particular emphasis on the anatomical bifurcation of the nerve into a superior and inferior division.

Full Text

Duke Authors

Cited Authors

  • Pecen, PE; Ramey, NA; Richard, MJ; Bhatti, MT

Published Date

  • 2012

Published In

Volume / Issue

  • 6 /

Start / End Page

  • 1941 - 1943

PubMed ID

  • 23225996

Pubmed Central ID

  • PMC3514055

Electronic International Standard Serial Number (EISSN)

  • 1177-5483

Digital Object Identifier (DOI)

  • 10.2147/OPTH.S30208


  • eng

Conference Location

  • New Zealand