Adenoid Cystic Carcinoma Presenting as Abducens Nerve Palsy Secondary to Cavernous Sinus Lesion.

BACKGROUND: We report a 61-year-old who presented with a right-sided abducens nerve palsy secondary to a middle cranial fossa adenoid cystic carcinoma (ACC) extending into the cavernous sinus.

PURPOSE: This case represents a unique presentation of intracranial ACC with a large middle cranial fossa mass and only a small extracranial component.

METHODS: Review of the literature was undertaken to identify cases of intracranial ACC and their range of presentations.

RESULTS: Our results show that this is the first reported case of an ACC presenting mostly as an intracranial mass with an isolated cranial nerve lesion.

CONCLUSION: Our case highlights the importance of a broad differential diagnosis, particularly in circumstances where there are atypical features of lesions on radiographic imaging.