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Cavernous sinus exploration.

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D Parkinson. 1992. Cavernous sinus exploration.. https://doi.org/10.3171/jns.1992.76.2.0341

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Lymphocytic hypophysitis: report of a case in a man with cavernous sinus involvement.

Lymphocytic hypophysitis (LH) is a rare inflammatory disease of the pituitary that produces hypopituitarism. It more commonly affects women during pregnancy or shortly after childbirth. Of the 34 reported cases only three have been males. We report the fourth known case of lymphocytic hypophysitis in a male who presented with hypopituitarism, diplopia, and cavernous sinus involvement. To our knowledge this is the second report of involvement of the cavernous sinus by LH. A comparative study of all four male cases is also presented. The findings reveal that the mean age at presentation in the male patients is 52.3, nearly 21 years older than that reported for female cases. Impotence with associated decrease in libido is the most common presenting symptom. Extraocular muscle palsy with associated infiltration of the cavernous sinus is an exclusive finding among male patients with LH. Concerning prognosis, none of the male patients regained pituitary function that had been lost at the time of presentation but required chronic replacement therapy.

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A rare case of malignant melanoma metastatic to the cavernous sinus and skull, with an unknown primary origin, is reported. A 46-year-old man noticed diplopia, lt. ptosis and swelling in the parietal and maxillary regions. The parietal skull tumor and the maxillary lymph node were excised and histological examination revealed malignant melanoma. Because of its roentogenological characteristics, the lesion of the cavernous sinus was also thought to be the site of metastasis of malignant melanoma. This case is rare because the initial symptom was cavernous sinus syndrome, and no involvement of brain parenchyma was observed.

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