Man with nasopharyngeal carcinoma presents with diplopia
A 59-year-old man with a medical history of nasopharyngeal carcinoma, prediabetes, hyperlipidemia and hypothyroidism was referred to us for progressive vertical diplopia that had worsened over several weeks.
The diplopia was present with upgaze and was worse at distance than at near. He also reported progressive drooping of the left upper eyelid over the same interval. He denied any prior episodes of diplopia as well as ocular pain, pain with extraocular movements, fever, chills, jaw claudication, weight loss or recent night sweats.
Regarding the patient’s oncologic history, his initial PET