Adie’s tonic pupil in recurrent adenoid cystic carcinoma of
The following case has been reported in the Delhi Journal of Ophthalmology. 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.

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