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The Official Scientific Journal of Delhi Ophthalmological Society
Adie’s Tonic Pupil in a Case of Recurrent Adenoid Cystic Carcinoma of Maxillary Sinus – An Ophthalmic Perspective
Prithviraj Udaya, Sairani Karanam 
Paediatric Ophthalmology, Sankara Eye Hospital, Guntur, Andhra Pradesh, India
Corresponding Author:
Prithviraj Udaya 
MBBS, DO
Paediatric Ophthalmology, 
Sankara Eye Hospital, Guntur, 
Andhra Pradesh, India
Email id: uprithviraj@gmail.com
Published Online: 30-JUL-2018
DOI: http://dx.doi.org/10.7869/djo.381
Abstract
A gentleman without signs of tumour recurrence until a year following surgery for adenoid cystic carcinoma (ACC) of the maxillary sinus, presented with binocular diplopia, defective vision in the right eye and numbness in the right forehead. Examination revealed a right Adie’s pupil that concurred with positive infraorbital nerve margins on intraoperative frozen section, indicating a perineural tumour spread. Diplopia and Hess charting verified a combined right sixth nerve and partial third nerve palsy. Neuroimaging confirmed extension of residual tumour to the right cavernous sinus apart from buckling of the right optic nerve. We report a unique case of recurrent ACC of maxillary sinus with partial cavernous sinus syndrome and an acquired Adie’s pupil consequent to intracranial extension and perineural spread.
Keywords : Adenoid cystic carcinoma; maxillary sinus; perineural; Adie’s tonic pupil
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