A 69-year-old woman presented with chronic, painful, progressive binocular diplopia. Examination showed deficits in multiple sequential cranial nerves (II, III, IV, V1,2,3, and VI). She was initially diagnosed with Tolosa-Hunt syndrome and had a partial response to systemic corticosteroids. Skull base biopsy eventually showed poorly differentiated carcinoma consistent with perineural spread of squamous cell carcinoma.

Original languageEnglish (US)
JournalSurvey of Ophthalmology
StateAccepted/In press - 2021


  • perineural invasion
  • squamous cell carcinoma
  • Tolosa-Hunt syndrome

ASJC Scopus subject areas

  • Ophthalmology

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