A 53-Year-Old Man Presenting With Diplopia and Cavitary Lung Nodules

A 53-year-old Chinese man presented with 1 week of worsening diplopia and left-sided facial droop. His symptoms developed during a readmission for elective drainage and curettage of a perianal abscess that recurred despite drainage 2 weeks before. He denied having other neurologic symptoms, and did not report any cough, sputum production, night sweats, or fever. He was a lifelong nonsmoker with a history of polymyositis treated with mycophenolate mofetil for the last 4 years. He had undergone surgical resection for jejunal adenocarcinoma 12 years prior to this presentation. No evidence of recurrence was detected on surveillance gastrointestinal endoscopies and CT scans.