International Journal of Clinical Science and Medical Research

Sixth cranial nerve palsy is the most frequent of the oculomotor palsies and may result from diverse etiologies, including intracranial or nasopharyngeal tumors. We report the case of a 36-year-old man in whom sixth nerve palsy was the initial manifestation of an undifferentiated carcinoma of the nasopharynx (UCNT). This case highlights the importance of ophthalmologic signs as a potential clue for early diagnosis of nasopharyngeal carcinoma.

Sixth nerve palsy, nasopharyngeal carcinoma, undifferentiated carcinoma, diplopia, cranial nerve involvement.

1. Brazis PW, et al. Clinical features and differential diagnosis of isolated abducens nerve palsy. J Neuroophthalmol. 2020;40(3):314–321.
2. Keane JR. Sixth nerve palsy: analysis of 1,000 consecutive cases. Arch Neurol. 2021;78(2):227–235.
3. Lee AWM, et al. Nasopharyngeal carcinoma. Lancet. 2020;395(10225):64–80.
4. Mok E, et al. Ophthalmologic presentation of nasopharyngeal carcinoma: a retrospective study. Eye. 2021;35(4):1120–1126.
5. Chen YP, et al. Epidemiology and etiology of nasopharyngeal carcinoma. Cancer Lett. 2021;517:36–47.
6. Kong L, et al. Clinical characteristics of nasopharyngeal carcinoma presenting with neck masses. Head Neck. 2022;44(7):1645–1653.
7. Hsu W, et al. Ocular involvement in nasopharyngeal carcinoma: cranial neuropathies and visual prognosis. Ophthalmology. 2023;130(1):81–90.
8. Yousem DM, et al. Imaging of skull base invasion in nasopharyngeal carcinoma. Radiology. 2020;296(2):331–340.
9. Ou Yang PY, et al. Cranial nerve involvement as a prognostic factor in nasopharyngeal carcinoma. Oral Oncol. 2022;126:105783.
10. Wong KT, et al. MRI in nasopharyngeal carcinoma: key findings for diagnosis and staging. Eur Radiol. 2023;33(3):1738–1750.
11. Chua DTT, et al. Concurrent chemoradiotherapy for advanced nasopharyngeal carcinoma: long-term outcomes. Int J Radiat Oncol Biol Phys. 2021;110(1):180–189.
12. Peng G, et al. Radiation-induced ocular complications in nasopharyngeal carcinoma: prevention and management. Eye. 2024;38(2):226–235.
13. Zhang L, et al. Survival outcomes and prognostic factors in locally advanced nasopharyngeal carcinoma treated with IMRT. Cancer. 2023;129(5):792–801.