technetium-tc-99m-medronate and Trigeminal-Neuralgia

A case is presented of metastatic tumor causing Jacod's syndrome: total ophthalmoplegia, blindness, and trigeminal neuralgia. Abnormal soft tissue invading the orbital apex, anterior clinoid process, and cavernous sinus was difficult to assess by CT and MRI, but dual-isotope SPECT including Tc-99m HMDP bone imaging and Tl-201 tumor imaging strongly suggested that the cause of this rare syndrome was a small metastatic tumor. Although the therapeutic effect was also difficult to assess by anatomic imaging alone, dual-isotope SPECT after radiation therapy showed a decline of tumor viability.

Topics: Aged; Blindness; Carcinoma, Non-Small-Cell Lung; Cavernous Sinus; Follow-Up Studies; Humans; Lung Neoplasms; Magnetic Resonance Imaging; Male; Ophthalmoplegia; Orbital Neoplasms; Radiopharmaceuticals; Skull Base Neoplasms; Sphenoid Bone; Syndrome; Technetium Tc 99m Medronate; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Trigeminal Neuralgia