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This article describes a 76 years old man that, after lung cancer surgery, showed left extrinsic oculomotor paralysis and contralateral paralysis of the superior rectus muscle associated with bilateral ptosis. Magnetic resonance imaging confirmed a rare situation characterized by an isolated metastasis in the region of the left third cranial nerve nucleus, probably compromising the superior rectus subnucleus and the central caudal nucleus, therefore justifying the bilateral oculomotor involvement.

This article describes a 76 years old man that, after lung cancer surgery, showed left extrinsic oculomotor paralysis and contralateral paralysis of the superior rectus muscle associated with bilateral ptosis. Magnetic resonance imaging confirmed a rare situation characterized by an isolated metastasis in the region of the left third cranial nerve nucleus, probably compromising the superior rectus subnucleus and the central caudal nucleus, therefore justifying the bilateral oculomotor involvement. O presente relato descreve um homem de 76 anos que, após cirurgia de câncer de pulmão apresentou paralisia oculomotora extrínseca à esquerda e paralisia contralateral do músculo reto superior, além de ptose palpebral bilateral. O exame de ressonância magnética evidenciou uma rara situação caracterizada por metástase isolada na região do núcleo do terceiro nervo craniano esquerdo provavelmente comprometendo o sub-núcleo do reto superior e o núcleo central caudal, justificando assim o envolvimento óculo motor bilateral.