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구형준,김태원,조규섭,노환중 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.11
We report on an unusual case of primary extranodal non-Hodgkins lymphoma of the sphenoid sinus invading cavernous sinus. A69-year-old male patient presented with left facial pain and headache. A nasal endoscopy revealed no specific finding in bothnasal cavity and no definite mass like lesion was found in the nasal cavity. Paranasal CT scans demonstrated mild haziness withoutbony erosion or thinning in left sphenoid sinus. Several months later, he complained of a ptosis and lateral gaze palsy of the lefteye when he gazed at the left side. Brain MRI showed a well enhanced lobulated mass in the left sphenoid sinus invading into theleft carvenous sinus and middle cranial fossa with left internal carotid artery encasement. Endoscopic biopsy via transnasal sphenoidotomywas performed under general anesthesia, and an easy fragile, yellowish, reddish mass in the sphenoid sinus was partiallyremoved. The mass had infiltrated into the lateral, inferior and superior wall of the left sphenoid sinus. Biopsy confirmed a diffusedlarge 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 combinationtherapy. (Korean J Otolaryngol 2006;49:1113-7)