Adult ; Female ; Horner Syndrome ; etiology ; Humans ; Neck Dissection ; Postoperative Complications ; Thyroid Neoplasms ; pathology ; surgery

OBJECTIVE: To evaluate clinical feature, diagnosis, treatment and prognosis of ganglioneuroma in the neck. METHOD: The medical records of 6 patients with cervical ganglioneuroma which were confirmed by pathology between 1995 and 2009 were retrospectively reviewed. RESULT: Patients with ganglioneuroma in the neck typically present with an asymptomatic neck mass. Neither imaging procedures nor fine needle aspiration made a definite diagnosis before surgery. All cases were operated, and developed Horner syndrome. With a median follow-up time of 5.9 years, all cases survived without local recurrence or distant metastasis. CONCLUSION Ganglioneuroma in the neck is a rare well differentiated benign tumour. Definite diagnosis only can be made after pathology. Complete surgical excision is the treatment of choice, as it will ensure thorough sampling of the tumour and cure. Postoperative prognosis is favorable if total resection.
Biopsy, Fine-Needle ; Ganglioneuroma ; pathology ; surgery ; Head and Neck Neoplasms ; pathology ; surgery ; Horner Syndrome ; etiology ; Humans ; Neoplasm Recurrence, Local ; Postoperative Complications ; Prognosis ; Retrospective Studies

A 68-year-old male patient presented with a week of sudden diplopia. He had been diagnosed with nasopharyngeal cancer 8 months prior and had undergone chemotherapy with radiotherapy. Eight-prism diopter right esotropia in the primary position and a remarkable limitation in abduction in his right eye were observed. Other pupillary disorders and lid drooping were not found. After three weeks, the marginal reflex distance 1 was 3 mm in the right eye and 5 mm in the left eye. The pupil diameter was 2.5 mm in the right eye, and 3 mm in the left eye under room illumination. Under darkened conditions, the pupil diameter was 3.5 mm in the right eye, and 5 mm in the left eye. After topical application of 0.5% apraclonidine, improvement in the right ptosis and reversal pupillary dilatation were observed. On brain magnetic resonance imaging, enhanced lesions on the right cavernous sinus, both sphenoidal sinuses, and skull base suggested the invasion of nasopharyngeal cancer. Lesions on the cavernous sinus need to be considered in cases of abducens nerve palsy and ipsilateral Horner's syndrome.
Abducens Nerve Diseases/*etiology ; Aged ; Carcinoma, Squamous Cell/complications/pathology/therapy ; Cavernous Sinus/pathology ; Combined Modality Therapy ; Horner Syndrome/*etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Nasopharyngeal Neoplasms/complications/pathology/therapy

A 55-year-old woman presented with diplopia following painful skin eruptions on the right upper extremity. On presentation, she was found to have 35 prism diopters of esotropia and an abduction limitation in the left eye. Two weeks later, she developed blepharoptosis and anisocoria with a smaller pupil in the right eye, which increased in the darkness. Cerebrospinal fluid analysis showed pleocytosis and a positive result for immunoglobulin G antibody to varicella zoster virus. She was diagnosed to have zoster meningitis with Horner's syndrome and contralateral abducens nerve palsy. After intravenous antiviral and steroid treatments, the vesicular eruptions and abducens nerve palsy improved. Horner's syndrome and diplopia resolved after six months. Here we present the first report of Horner's syndrome and contralateral abducens nerve palsy associated with zoster meningitis.
Abducens Nerve Diseases/diagnosis/*etiology ; Antibodies, Viral/*analysis ; Diagnosis, Differential ; Electromyography ; Female ; Follow-Up Studies ; Herpes Zoster/*complications/diagnosis/virology ; Herpesvirus 3, Human/*immunology ; Horner Syndrome/diagnosis/*etiology ; Humans ; Magnetic Resonance Imaging ; Meningitis/*complications/diagnosis/virology ; Middle Aged ; Tomography, X-Ray Computed