Chondrosarcoma of the petrous apex with nerve abducens involvement in a woman with pre-existing contralateral amblyopia

BMJ Case Rep. 2023 Sep 20;16(9):e256273. doi: 10.1136/bcr-2023-256273.

Abstract

We report about a case of a woman in her 50s with a chondrosarcoma of the petrous apex. She has a strabism due to a right-sided amblyopia since childhood and noticed a slowly progressive squint angle in the last months. Her general practitioner (GP) referred her to an ophthalmologist who diagnosed a left abducens paresis and initiated an MRI demonstrating a mass in the left petrous apex. A transnasal endoscopic transsphenoidal biopsy revealed a grade I chondrosarcoma. The patient underwent an endoscopic transsphenoidal anterior petrosectomy approach with complete removal of the tumour. After surgery the squint angle gradually improved to previous levels, so that the patient was able to resume her work. This report demonstrates that even slight changes of a squint angle without diplopia, in this case because of pre-existing amblyopia, could be a hallmark of an intracranial process.

Keywords: ear, nose and throat/otolaryngology; head and neck surgery; neuroopthalmology; neurosurgery; otolaryngology / ENT.

Publication types

  • Case Reports

MeSH terms

  • Amblyopia*
  • Bone Neoplasms*
  • Child
  • Chondrosarcoma* / complications
  • Chondrosarcoma* / diagnostic imaging
  • Chondrosarcoma* / surgery
  • Female
  • Humans
  • Petrous Bone / diagnostic imaging
  • Petrous Bone / surgery
  • Strabismus*