1
|
Zou M, Wang YH, Dong YF, Lai XJ, Li JC. Clinical and sonographic features for the preoperative prediction of lymph nodes posterior to the right recurrent laryngeal nerve metastasis in patients with papillary thyroid carcinoma. J Endocrinol Invest 2020; 43:1511-1517. [PMID: 32253729 DOI: 10.1007/s40618-020-01238-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 03/23/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate clinical and sonographic features predictive of lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN) metastasis in patients diagnosed with papillary thyroid carcinoma (PTC). METHODS We retrospectively reviewed the clinical records and ultrasound (US) images of 479 consecutive PTC patients who received total thyroidectomy or right lobectomy with central neck dissection (CND) between October 2017 and October 2019. Univariate and multivariate analyses were performed to identify clinical and sonographic features associated with LN-prRLN metastasis. Receiver operating characteristic (ROC) analysis was applied to evaluate the efficacy of clinical and sonographic features in the preoperative prediction of LN-prRLN metastasis. RESULTS Overall, 127 (26.5%) patients had LN-prRLN metastasis. Multivariate logistic regression analysis showed that age < 45 years (p = 0.005; OR 2.155; 95% CI 1.262-3.683), male sex (p = 0.043; OR 1.657; 95% CI 1.016-2.704), tumor diameter > 1 cm (p = 0.042; OR 1.702; 95% CI 1.019-2.842), microcalcifications (p = 0.022; OR 1.980; 95% CI 1.104-3.551), and US-detected lateral compartment lymph node (LLN) metastasis (p = 0.001; OR 2.578; 95% CI 1.500-4.430) were independent risk factors for LN-prRLN metastasis. ROC analysis revealed that the multivariate logistic regression model had good accuracy in predicting LN-prRLN metastasis, with an area under the ROC curve of 0.758. CONCLUSIONS Age less than 45 years, male sex, tumor diameter larger than 1 cm, microcalcifications, and US-detected LLN metastasis may preoperatively predict LN-prRLN metastasis.
Collapse
Affiliation(s)
- M Zou
- Department of Ultrasound, Peking Union Medical College Hospital, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - Y H Wang
- Department of Ultrasound, Peking Union Medical College Hospital, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - Y F Dong
- Department of Ultrasound, Peking Union Medical College Hospital, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - X J Lai
- Department of Ultrasound, Peking Union Medical College Hospital, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
| | - J C Li
- Department of Ultrasound, Peking Union Medical College Hospital, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
| |
Collapse
|
2
|
Costentin G, Bouwyn JP, Macaigne V, Théry JC, Lefaucheur R. Loss of intrinsic and extrinsic motility of third nerve revealing breast cancer recurrence. Acta Neurol Belg 2020; 120:425-427. [PMID: 29869779 DOI: 10.1007/s13760-018-0960-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 06/03/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Guillaume Costentin
- Department of Neurology, Rouen University Hospital and University of Rouen, 76031, Rouen Cedex, France.
| | - Jean-Paul Bouwyn
- Department of Neurology, Rouen University Hospital and University of Rouen, 76031, Rouen Cedex, France
| | - Valérie Macaigne
- Department of Radiology, Rouen University Hospital and University of Rouen, Rouen Cedex, France
| | | | - Romain Lefaucheur
- Department of Neurology, Rouen University Hospital and University of Rouen, 76031, Rouen Cedex, France
| |
Collapse
|
3
|
Garcia-Madrona S, Corral-Corral I. [Occipital condyle syndrome as the first symptom of a metastatic hepatocellular carcinoma. Two case reports]. Rev Neurol 2018; 66:154-156. [PMID: 29480511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Occipital condyle syndrome consists of the presence of unilateral occipital headache exacerbated by moving the head and is accompanied by paralysis of the ipsilateral hypoglossal nerve. One of its causes is infiltration of the base of the skull by bone metastases, especially those affecting the hypoglossal nerve due to infiltration as it passes through the osseous canal. CASE REPORTS We report two clinical cases of occipital condyle syndrome secondary to metastatic hepatocarcinoma. The first is that of a 52-year-old male with liver cirrhosis secondary to liver pathology caused by hepatitis C virus with occipital condyle syndrome as the presenting symptom in disseminated hepatocarcinoma. The second case is that of a 56-year-old male after recurrence of hepatocarcinoma following a liver transplant, despite not fulfilling the Milan criteria. CONCLUSION Occipital condyle syndrome is an alarm symptom and requires a thorough study by means of imaging tests, since it may be the first symptom of an undetected hepatocarcinoma.
Collapse
|
4
|
Affiliation(s)
- Walter T Lee
- Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
| | | |
Collapse
|
5
|
Abstract
Neurological disorders and conditions affecting the maxillofacial region result in disabilities that affect an individual's functioning. Sensory or motor disturbances of the nerves may be caused by trauma, infections, pressure effect or infiltration by tumours or other health conditions. Two rare cases of nerve afflictions are described here with their typical clinical features. The first case had an involvement of maxillary, mandibular and ophthalmic divisions of the trigeminal nerve (sensory) due to herpes zoster infection in a very young patient and the second case had a unilateral isolated hypoglossal nerve palsy (motor) secondary to infiltration of the nerve by carcinoma of pyriform fossa.
Collapse
Affiliation(s)
- Smitha Rani Thada
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - Rohit Gadda
- Department of Oral Medicine and Radiology, Mahatma Gandhi Mission's Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Keerthilatha Pai
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Karnataka, India
| |
Collapse
|
6
|
Schulkes KJG, Bossink AWJ. Unilateral tongue atrophy and pulmonary malignancy. Neth J Med 2013; 71:32-35. [PMID: 23412822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- K J G Schulkes
- Department of Pulmonology, Diakonessenhuis, Utrecht, the Netherlands.
| | | |
Collapse
|
7
|
Hotomi M, Sugitani I, Toda K, Kawabata K, Fujimoto Y. A Novel Definition of Extrathyroidal Invasion for Patients with Papillary Thyroid Carcinoma for Predicting Prognosis. World J Surg 2012; 36:1231-40. [PMID: 22402972 DOI: 10.1007/s00268-012-1518-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Muneki Hotomi
- Division of Head and Neck, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo 135-8550, Japan
| | | | | | | | | |
Collapse
|
8
|
Affiliation(s)
- Kokoro Ozaki
- Department of Neurology, Yokosuka Kyosai Hospital, Japan
| | | | | | | |
Collapse
|
9
|
Sundaram ANE, Simmons Z, Towfighi J, Sheehan J, Reichwein R. Contralateral cranial polyneuropathy due to perineural invasion by a cutaneous squamous cell carcinoma. J Clin Neuromuscul Dis 2010; 11:132-136. [PMID: 20215987 DOI: 10.1097/cnd.0b013e3181ca3421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Cutaneous malignancies may spread to underlying nerves, a process known as perineural invasion (PNI). We report a patient who was found to have PNI presenting as a cranial polyneuropathy on the contralateral side of the face many years after the resection of a squamous cell carcinoma. All diagnostic testing was unrevealing until nerve biopsy was performed. This emphasizes the long asymptomatic period between treatment of a cutaneous malignancy and detection of PNI, and the development of PNI at a site distant from the original malignancy. Biopsy of a clinically involved nerve may permit diagnosis of PNI when other studies are normal.
Collapse
Affiliation(s)
- Arun N E Sundaram
- Department of Neurology, Penn State College of Medicine, Hershey Medical Center, Hershey, PA 17033, USA
| | | | | | | | | |
Collapse
|
10
|
García Carreira MC, Pomares Quintana N, Delgado Ballestero T. [Peripheral facial paralysis as a first symptom of a pulmonary metastasis]. Neurologia 2009; 24:346-347. [PMID: 20050119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
|
11
|
|
12
|
Walters H, Lewis E, Wolper R, Yachnis AT, Green J, Lewis S. Neurotropic melanoma of the trigeminal nerve: a case of atypical facial pain. J Oral Maxillofac Surg 2008; 66:547-50. [PMID: 18280392 DOI: 10.1016/j.joms.2006.11.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2006] [Revised: 10/11/2006] [Accepted: 11/17/2006] [Indexed: 11/18/2022]
Affiliation(s)
- Hugh Walters
- General Surgery, University of Florida College of Medicine, Gainesville, FL, USA
| | | | | | | | | | | |
Collapse
|
13
|
Vellin JF, Achim V, Sinardet D, Gabrillargues J, Mom T, Gilain L. Rapidly developing leptomeningeal carcinomatosis following anterior skull base surgery: a case report. Auris Nasus Larynx 2007; 34:565-7. [PMID: 17507192 DOI: 10.1016/j.anl.2007.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2006] [Revised: 03/20/2007] [Accepted: 03/22/2007] [Indexed: 11/27/2022]
Abstract
Leptomeningeal carcinomatosis is rare in evolution of head and neck cancers. Prognosis is poor and treatment is through supportive care. We report an atypical rapid post-operative leptomeningeal carcinomatosis after skull base resection for an ethmoidal adenocarcinoma. The anterior skull base resection was near-total and we suspect a seeding of subarachnoid space either before surgery, either during surgical extirpation or from the residual intracranial nodule. It is the first description of rapid LMC after surgery (less than 1 month). Post-operative MRI diagnosed the LMC through the detection of contrast enhancing leptomeningeal nodules at bilateral second and eighth cranial nerves and at bilateral interpedoncular area. A strong index of suspicion along with clinical and radiological correlation is essential to arrive at a correct diagnosis. Otolaryngologists should be aware of the possibility of leptomeningeal carcinomatosis, before or after surgery, in a patient presents with an appropriate constellation of neurologic symptoms and a history of cancer.
Collapse
Affiliation(s)
- Jean-François Vellin
- Department of Otorhinolaryngology and Head Neck Surgery, Gabriel Montpied Teaching Hospital Network, University of Clermont 1, rue Montalembert, F-63000 Clermont-Ferrand, France.
| | | | | | | | | | | |
Collapse
|
14
|
Sone M, Katayama N, Otake N, Sato E, Fujimoto Y, Ito M, Nakashima T. Characterizing the auditory changes in tumor metastasis to the bilateral internal auditory canals. J Clin Neurosci 2007; 14:470-3. [PMID: 17386369 DOI: 10.1016/j.jocn.2005.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2005] [Accepted: 11/27/2005] [Indexed: 11/25/2022]
Abstract
We report the changes in auditory function in a patient with tumor metastasis to the bilateral internal auditory canals (IAC). The hearing gradually deteriorated at frequencies below 1 kHz and above 4 kHz, with the auditory brainstem response (ABR) eventually becoming absent in both ears. However, distortion product otoacoustic emissions (DPOAE) were present at low frequencies, which suggests that the organ of Corti in its upper turn remained unaffected by tumor invasion. Metastatic tumors in the bilateral IAC have been reported to mimic neurofibromatosis type 2, and radiological differentiation from acoustic schwannoma is difficult. We characterize the hearing deterioration caused by metastasis of malignant tumors in the IAC.
Collapse
Affiliation(s)
- Michihiko Sone
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
| | | | | | | | | | | | | |
Collapse
|
15
|
Abstract
AbstractThe hypoglossal nerve is an underrated nerve usually consigned to a few words in anatomical text books, under the last four cranial nerves. However, paralysis of this nerve may be the first indication of a serious underlying disorder. Excluding previous surgery, radiotherapy and trauma, 50 per cent of cases of isolated hypoglossal nerve palsy are idiopathic. A further 20 per cent are malignant, 20 per cent are vascular and 10 per cent are due to miscellaneous causes. Presentation of an isolated hypoglossal nerve palsy is therefore an ominous sign. There is confusion over both cause and investigation, and management protocols for isolated hypoglossal nerve palsy are ill-defined. We present a case of isolated hypoglossal palsy which was due to a metastatic skull base deposit. This case illustrates the fact that magnetic resonance imaging is the investigation of choice in assessing the entire course of the hypoglossal nerve.
Collapse
Affiliation(s)
- S G Khoo
- Department of Otolaryngology/Head and Neck Surgery, Mid-Western Regional Hospital, Limerick, Ireland.
| | | | | | | |
Collapse
|
16
|
Borges A, Casselman J. Imaging the cranial nerves: part II: primary and secondary neoplastic conditions and neurovascular conflicts. Eur Radiol 2007; 17:2332-44. [PMID: 17268799 DOI: 10.1007/s00330-006-0572-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2006] [Accepted: 12/28/2006] [Indexed: 11/29/2022]
Abstract
There have been unprecedented improvements in cross-sectional imaging in the last decades. The emergence of volumetric CT, higher field MR scanners and higher resolution MR sequences is largely responsible for the increasing diagnostic yield of imaging in patients presenting with cranial nerve deficits. The introduction of parallel MR imaging in combination with small surface coils allows the depiction of submillimetric nerves and nerve branches, and volumetric CT and MR imaging is able to provide high quality multiplanar and curved reconstructions that can follow the often complex course of cranial nerves. Seeking the cause of a cranial nerve deficit is a common indication for imaging, and it is not uncommon that radiologists are the first specialists to see a patient with a cranial neuropathy. To increase the diagnostic yield of imaging, high-resolution studies with smaller fields of view are required. To keep imaging studies within a reasonable time frame, it is mandatory to tailor the study according to neuro-topographic testing. This review article focuses on the contribution of current imaging techniques in the depiction of primary and secondary neoplastic conditions affecting the cranial nerves as well as on neurovascular conflicts, an increasingly recognized cause of cranial neuralgias.
Collapse
Affiliation(s)
- Alexandra Borges
- Radiology Department, Instituto Português de Oncologia Francisco Gentil- Centro de Lisboa, Rua Professor Lima Basto, 1093 Lisboa Codex, Portugal.
| | | |
Collapse
|
17
|
Abstract
We describe a rare case of HCV-related recurrent multiple hepatocellular carcinoma (HCC) metastasizing to the skull base involving multiple cranial nerves in a 50-year-old woman. The patient presented with symptoms of ptosis, fixation of the right eyeball, and left abducens palsy, indicating disturbances of the right oculomotor and trochlear nerves and bilateral abducens nerves. Brain contrast-enhanced computed tomography (CT) revealed an ill-defined mass with abnormal enhancement around the sella turcica. Brain magnetic resonance imaging (MRI) disclosed that the mass involved the clivus, cavernous sinus, and petrous apex. On contrast-enhanced MRI with gadolinium-chelated contrast medium, the mass showed inhomogeneous intermediate enhancement. The diagnosis of metastatic HCC to the skull base was made on the basis of neurological findings and imaging studies including CT and MRI, without histological examinations. Further studies may provide insights into various methods for diagnosing HCC metastasizing to the craniospinal area.
Collapse
Affiliation(s)
- Soo Ryang Kim
- Department of Gastroenterology, Kobe Asahi Hospital, and Department of Neurology, Kobe University Hospital, 653-0801, Japan.
| | | | | | | | | | | | | |
Collapse
|
18
|
Chang Y, Thompson H, Reed N, Penderis J. Clinical and magnetic resonance imaging features of nasopharyngeal lymphoma in two cats with concurrent intracranial mass. J Small Anim Pract 2006; 47:678-81. [PMID: 17076793 DOI: 10.1111/j.1748-5827.2006.00151.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Lymphoma is reported to be the most common nasal and second most common intracranial neoplasm in cats. Intracranial lymphoma may occur as a primary central nervous system lymphoma or as part of multi-centric disease. Two cats were presented with histopathologically confirmed nasopharyngeal lymphoma and concurrent mass within the middle fossa of the cranial cavity, with magnetic resonance imaging suggestive of direct communication. Both cats demonstrated evidence of bilateral oculomotor nerve deficits and upper respiratory tract noise. In one cat, bilateral optic nerve deficits were also present. The magnetic resonance imaging features were similar in both cases and demonstrated a contrast-enhancing intracranial mass on the ventral aspect of the middle fossa of the cranial cavity and an adjacent mass arising from the dorsal aspect of the nasopharynx. Lymphoma should be included as an important differential diagnosis in cats presented with middle cranial fossa syndrome (in particular ophthalmoplegia) and stertor.
Collapse
Affiliation(s)
- Y Chang
- Division of Pathological Science, Faculty of Veterinary Medicine, University of Glasgow, Bearsden Road, Bearsden, Glasgow G61 1QH
| | | | | | | |
Collapse
|
19
|
Abstract
Primary malignant lesions in the orbit are relatively uncommon. However, the orbits are frequently involved in haematogeneous metastasis or by direct extension from malignancies originating from the adjacent nasal cavity or paranasal sinuses. This paper focuses on the more commonly encountered primary orbital malignancies and the mapping of tumour spread into the orbits.
Collapse
Affiliation(s)
- V F H Chong
- Department of Diagnostic Radiology, National University Hospital, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore.
| |
Collapse
|
20
|
Koizuka S, Saito S, Kubo K, Tomioka A, Takazawa T, Sakurazawa S, Goto F. Percutaneous radio-frequency mandibular nerve rhizotomy guided by CT fluoroscopy. AJNR Am J Neuroradiol 2006; 27:1647-8. [PMID: 16971604 PMCID: PMC8139758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
We describe a new method for radio-frequency mandibular nerve rhizotomy under CT fluoroscopy. A patient with cancer had severe intractable and drug-resistant pain in his left mandibular region. Because he had an anatomic deformity due to cancer invasion and radiation therapy, we planned a mandibular nerve rhizotomy under CT fluoroscopic imaging. The needle was advanced to the mandibular nerve just caudal to the foramen ovale under real-time CT fluoroscopy, avoiding the cancer region. Pain scores of the patient were reduced after the nerve rhizotomy, without any complications.
Collapse
Affiliation(s)
- S Koizuka
- Department of Anesthesiology, Gunma University Graduate School of Medicine, Maebashi, Japan.
| | | | | | | | | | | | | |
Collapse
|
21
|
Maranhão-Filho P, Pires MEP. Metastasis to the unilateral oculomotor nucleus complex: case report. Arq Neuro-Psiquiatr 2006; 64:520-2. [PMID: 16917631 DOI: 10.1590/s0004-282x2006000300032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2005] [Accepted: 03/02/2006] [Indexed: 11/22/2022]
Abstract
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.
Collapse
Affiliation(s)
- Péricles Maranhão-Filho
- National Cancer Institute of Rio de Janeiro, Av. Canal de Marapendi 1680/1802, 22631-050 Rio de Janeiro RJ, Brazil
| | | |
Collapse
|
22
|
Valenzuela AA, Whitehead KJ, Sullivan TJ. Ocular Adnexal Pseudo-Cyst Formation as a Characteristic Feature of Perineural Spread in Squamous Cell Carcinoma. Ophthalmic Plast Reconstr Surg 2006; 22:201-5. [PMID: 16714930 DOI: 10.1097/01.iop.0000218259.19584.a8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To report the clinical features in a series of patients with perineural spread of squamous cell carcinoma involving periorbital nerves that presented with clinical and/or imaging evidence of pseudo-cystic transformation along the involved nerves. METHODS A noncomparative, retrospective chart review of the clinical and imaging findings of patients attending a regional orbital surgery department between 1998 and 2005, presenting with a pseudo-cystic orbital mass on clinical examination and/or imaging, which proved to be due to perineural squamous cell carcinoma on histopathology. RESULTS The study included 8 male patients with a mean age at referral of 66 +/- 11 years. All cases had associated cutaneous squamous cell carcinoma involving the face or scalp, and, in 4 cases, the primary tumor could be identified in the vicinity of the affected orbit. The duration of the symptoms varied from 5 weeks to 9 years (24 +/- 36 months). Altered sensation, including formication and hypo-esthesia in the V1 and V2 trigeminal division, motor nerve palsies, and ptosis in conjunction with a palpable periorbital mass, were the most common presentations. The cystic tumor deposits were assessed histologically with both hematoxylin and eosin and immunoperoxidase stains (S100 protein for neural structures identification and MNF116 as a keratin marker). This demonstrated malignant squamous epithelium both within and around the wall of the tumor deposit and, in continuity, within the nerve running through the lesion. Some nerves showed substantial areas of fibrosis, representing obliteration of the nerve structure caused by involvement by tumor. Treatment modalities included surgical debulking, exenteration, radiotherapy, and combined chemo-radiotherapy. Mean follow-up was 29 +/- 23 months. Eight patients (87.5%) remain alive, and five of them show no evidence of disease. One patient died after progression of the malignancy. CONCLUSIONS The presence of a cystic lesion in association with sensory or motor deficit in the periorbital region should suggest a diagnosis of perineural spread from a cutaneous squamous cell carcinoma. Because these patients may present to the ophthalmologist first, an awareness of this entity is of critical importance to avoid the delayed diagnosis seen in half of our cases.
Collapse
Affiliation(s)
- Alejandra A Valenzuela
- Eyelid, Lacrimal, and Orbital Clinic, Department of Ophthalmology, Division of Surgery, Royal Brisbane and Women's Hospital and the University of Queensland Medical School Australia
| | | | | |
Collapse
|
23
|
Kim JH, Jang JH, Koh SB. A case of neurolymphomatosis involving cranial nerves: MRI and fusion PET-CT findings. J Neurooncol 2006; 80:209-10. [PMID: 16645712 DOI: 10.1007/s11060-006-9164-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2006] [Accepted: 03/27/2006] [Indexed: 10/24/2022]
|
24
|
Suryanarayanan R, Dezso A, Ramsden RT, Gillespie JE. Metastatic carcinoma mimicking a facial nerve schwannoma: the role of computerized tomography in diagnosis. J Laryngol Otol 2006; 119:1010-2. [PMID: 16354372 DOI: 10.1258/002221505775010788] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Secondary deposits in the temporal bone are uncommon but well recognized. Such tumours may involve the facial nerve by direct extension of the destructive process into the fallopian canal. We present a rare case of metastasis from a breast carcinoma in the facial nerve itself, involving the nerve in the internal acoustic meatus with extension into the labyrinthine segment, the first genu and into the middle-ear segment. The rest of the temporal bone was not involved. The lesion resembled a facial schwannoma on a routine magnetic resonance (MR) image. The diagnosis was confirmed after a post-operative computed tomography (CT) scan showed another separate secondary deposit in the basisphenoid. Histology was consistent with secondary tumour from a breast carcinoma. The case highlights the importance of keeping a high degree of suspicion for metastatic tumours in patients with a previous history of malignancy and the usefulness of CT scan in the evaluation of such cases.
Collapse
Affiliation(s)
- R Suryanarayanan
- Department of Otolaryngology, Head and Neck Surgery, Manchester Royal Infirmary, Manchester, UK
| | | | | | | |
Collapse
|
25
|
Suzukawa K, Yamasoba T, Tsuzuku T, Kaga K. Are vestibular sensory cells preserved after destruction of Scarpa's ganglion? A study based on metastatic tumors of temporal bone. Otol Neurotol 2006; 26:1191-5. [PMID: 16272940 DOI: 10.1097/01.mao.0000194889.44023.30] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The contribution of nerve fibers to the maintenance of vestibular sensory cells is a controversial issue in previous studies using animals and has not yet been studied in humans. The authors investigated this issue by observing vestibular end organs in the temporal bone of three patients in whom the internal auditory canal was infiltrated with tumor cells, and Scarpa's ganglion cells showed complete degeneration. STUDY DESIGN Retrospective case review. SETTING University Hospital, Department of Otolaryngology. PATIENTS Three patients with malignant metastatic temporal bone tumors. INTERVENTION We investigated the preservative state of vestibular sensory hair cells with the Scalpa's ganglion was destructed. MAIN OUTCOME MEASURES Maintenances of vestibular sensory hair cells. RESULTS We found that sensory cells were intact despite the severe destruction of Scarpa's ganglion cells in two of the patients. CONCLUSION The findings suggest that human vestibular sensory cells can be maintained for an indefinite period after denervation.
Collapse
Affiliation(s)
- Keigo Suzukawa
- Department of Otolaryngology, Hitachi General Hospital, Hitachi, Japan.
| | | | | | | |
Collapse
|
26
|
Morís G, Pérez-Peña M, Miranda E, López Anglada J, Ribacoba R, González C. Trigeminal mononeuropathy: first clinical manifestation of breast cancer. Eur Neurol 2006; 54:212-3. [PMID: 16401894 DOI: 10.1159/000090711] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2005] [Accepted: 09/15/2005] [Indexed: 11/19/2022]
|
27
|
Abstract
Perineural tumor spread (PNS) of head and neck malignancies is a well-known form of metastatic disease in which a lesion can migrate away from the primary site along the endoneurium or perineurium. This pattern of spread may create a poor prognosis and require aggressive treatment when curable. Although representative histologies are squamous cell carcinoma and adenoid cystic carcinoma, other malignancies such as malignant lymphoma and sarcoma also can show such a specific pattern of extent. PNS can be insidious, often delaying diagnosis. Knowledge of anatomy of the nerves is crucial in the imaging diagnosis of PNS, to detect early curable disease. The facial nerve and the maxillary and mandibular divisions of the trigeminal nerve are most commonly affected. General clinical issues and the diagnostic imaging of PNS along these nerves are discussed in the current article.
Collapse
Affiliation(s)
- Hiroya Ojiri
- Department of Radiology, Jikei University School of Medicine, Tokyo 105-8461, Japan
| |
Collapse
|
28
|
|
29
|
Weber T, Hoksch B, Körner M, Jüngling F, Schmid RA. Positive positron emission tomography scan in sarcoidosis and two challenging cases of metastatic cancer. CASE 3. Hoarseness caused by cancer metastasis to the vagus nerve. J Clin Oncol 2005; 23:8909-10. [PMID: 16314653 DOI: 10.1200/jco.2005.04.0865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Thomas Weber
- Division of General Thoracic Surgery, University Hospital Berne, Bern, Switzerland
| | | | | | | | | |
Collapse
|
30
|
Affiliation(s)
- P Kumar
- Department of Urology, St Bartholomew's Hospital, London EC1A 7BE
| | | | | |
Collapse
|
31
|
Abstract
BACKGROUND Desmoplastic neurotropic melanoma (DNM) and neurotropic melanoma (NM), rare lesions of the head and neck, often present as a benign-appearing nodule which later progresses to cranial nerve involvement. OBJECTIVE To discuss treatment and outcome of 3 cases of DNM/NM of the lower lip. METHODS Three case reports with 12- to 54-month follow-up and literature review. RESULTS The first case had an initial excision of melanoma of his lower lip and presented 16 years later with severe bilateral atrophy of his muscles of mastication with NM and underwent intensity modulated radiation therapy but no further resection. We also report two other cases of DNM of the lip, one of which received gamma knife radiosurgery for intracranial extension. LIMITATIONS Small retrospective case series. CONCLUSIONS Locoregional recurrences from DNM are more common than distant metastasis warranting vigilant surveillance following resection of the initial lesion. Radiation therapy and gamma knife radiosurgery may be used for cases of unresectable recurrences.
Collapse
Affiliation(s)
- Doris Lin
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California 94143-0342, USA
| | | | | | | |
Collapse
|
32
|
Abstract
BACKGROUND Although described in several reports of internal malignancies metastasizing to the skin, zosteriform metastases have been reported in only two cases of cutaneous squamous cell carcinoma (SCC). In both of these reports, the patients were immunosuppressed related to renal transplantation. OBJECTIVE We present a case of an immunocompetent patient with zosteriform metastases originating from a recurrent cutaneous SCC. The lesions were present along the maxillary division of the trigeminal nerve. METHODS Biopsies from eight lesions were studied using hematoxylin and eosin (H&E) and with immunohistochemistry. RESULTS Neural involvement was detected in H&E preparations before and during excision of the metastatic nodules by Mohs micrographic surgery. The tumor cells reacted with antikeratin antibodies. The patient has had no evidence of recurrence or metastases 30 months following surgery. CONCLUSION To our knowledge, this is the first case of cutaneous SCC with zosteriform metastases in a patient with an intact immune system. SCC should be included in the differential diagnosis of lesions presenting in a dermatomal distribution.
Collapse
Affiliation(s)
- Joel L Cohen
- Department of Dermatology, Universtity of Colorado, Denver, Colorado, USA
| | | | | | | |
Collapse
|
33
|
Streams BN, Eaton JS, Zelac DE. Perineural spread of squamous cell carcinoma involving the spinal accessory nerve in an immunocompromised organ transplant recipient. Dermatol Surg 2005; 31:599-601. [PMID: 15962752 DOI: 10.1111/j.1524-4725.2005.31173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Squamous cell carcinoma is the second most common cutaneous malignancy in humans, affecting approximately 200,000 people in the United States each year. In immunocompromised patients, squamous cell carcinoma is the most common skin cancer, and it also tends to behave more aggressively than in immunocompetent patients. OBJECTIVE We describe an immunocompromised patient, previously treated for a squamous cell carcinoma of the left posterior shoulder, who subsequently developed a cord-like, intraneural metastasis of the spinal accessory nerve. RESULTS The patient presented with a 3-month history of lancinating pain of the left neck and shoulder. He had been treated previously for a squamous cell carcinoma of the left posterior shoulder, which subsequently recurred twice. On examination, a cord-like mass was palpable along the path of the spinal accessory nerve. Given the aggressive nature of this patient's squamous cell carcinoma, surgical exploration was performed. Frozen-section analysis of the spinal accessory nerve and of the multiple supraclavicular nerves revealed perineural and intraneural squamous cell carcinoma. CONCLUSION To our knowledge, this is the first reported case of a primary cutaneous squamous cell carcinoma of the trunk or extremity metastasizing to a cranial nerve.
Collapse
Affiliation(s)
- Brian N Streams
- Divisions of Mobs Surgery and Head and Neck Surgery, Scripps Clinic, La Jolla, California, USA.
| | | | | |
Collapse
|
34
|
Grosshans E. [Neurotropic metastases or epidermoid metaplasia of the perineural cells]. Ann Dermatol Venereol 2004; 131:997-8. [PMID: 15602391 DOI: 10.1016/s0151-9638(04)93814-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
35
|
Affiliation(s)
- Gary R Conrad
- Department of Diagnostic Radiology, The University of Kentucky Chandler Medical Center, Lexington, Kentucky 40536-0293, USA.
| | | | | |
Collapse
|
36
|
Abstract
The natural history of bronchogenic carcinoma shows that 42% of patients are diagnosed with cancer-related neurological complications either at initial presentation or at follow-up that can be separated in 3 different categories: - locoregional involvement of cervicothoracic nerves (recurrent laryngeal nerves, phrenic and vagus nerves, brachial plexus and sympathetic cervical chains), - metastatic disease characterized by intracranial lesions (brain, meningeal, ependymal and pituitary metastases) and spinal (extradural, subarachnoid and medullary metastases) lesions, - paraneoplastic syndromes including limbic encephalitis, Lambert-Eaton syndrome and paraneoplastic cerebellar degeneration. These neurological disorders usually are associated with advanced cancer for which radical surgical management seldom is indicated. All imaging studies performed at the time of initial staging for bronchogenic carcinoma should therefore be carefully reviewed in order to detect signs that could suggest the presence of one or several neurological complications. The goals of this paper are to describe the clinical signs and to illustrate the imaging features of neurological complications related to bronchogenic carcinoma at conventional radiography, CT and MRI.
Collapse
Affiliation(s)
- V Adjenou
- Services de radiologie adultes et neuroradiologie
| | | | | | | | | | | |
Collapse
|
37
|
Falcioni M, Piccirillo E, Di Trapani G, Romano G, Russo A. Internal auditory canal metastasis. Acta Otorhinolaryngol Ital 2004; 24:78-82. [PMID: 15468996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
This report deals with 3 cases of internal auditory canal metastasis, an extremely rare lesion, few cases having been reported in the international literature. Since pre-operative diagnosis is fundamental in the planning of a correct therapeutic strategy, it is important that the neurotologist be aware of the possibility of their occurrence in this particular area. Metastasis can occur unilaterally as well as bilaterally; the latter being the case in 1 of the patients described herein. Correct pre-operative diagnosis is particularly difficult in patients in whom the primary tumour has not been detected at the time of identification of the lesion in the internal auditory canal. The only characteristic, specific of metastasis, is the presence of multifocal cerebral lesions. However, these were detected in only 1 of the present cases. On the contrary, in cases of a single metastasis, both magnetic resonance imaging and computed tomography usually fail to show any distinctive feature when compared to the most common tumours of the internal auditory canal (vestibular schwannomas and meningiomas). Bilateral metastases can also be misdiagnosed as neurofibromatosis type 2. Clinical data that should alert the clinician are: rapidly progressive sensorineural hearing loss, followed by onset of progressive facial nerve weakness. Radiotherapy and/or chemotherapy are the two main treatment modalities, while surgical removal is reserved for selected cases of a single metastasis. Albeit, due to the paucity of specific radiological and clinical characteristics, surgical removal is often necessary to reach the correct diagnosis, as occurred in 2 of the present patients.
Collapse
|
38
|
Abstract
Perineural invasion is a common mechanism of spread of head and neck cancers. Imaging plays an important role in detection of this condition because a large number of patients with perineural spread (PNS) are clinically asymptomatic. Accurate detection of PNS requires an understanding of anatomy of commonly involved neural pathways. High level of suspicion on the part of the radiologist, awareness of common imaging signs of PNS and careful attention to imaging technique can aid in earlier detection of this condition.
Collapse
Affiliation(s)
- Dheeraj Gandhi
- Department of Radiology, Division of Neuroradiology, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0030, USA.
| | | | | |
Collapse
|
39
|
Abstract
INTRODUCTION Epidermoid skin carcinoma is the second most frequent skin cancer. It is rarely considered as aggressive. Other than its extension through the blood of lymph circulation, perineural invasion is also a significant form of tumoral invasion. We report a case of recurrent epidermoid skin carcinoma beginning with a neurological symptomatology. OBSERVATION A 77 year-old man with a history of right fronto-temporal epidermoid skin carcinoma turned up at our clinic with a ptosis of the right eyelid and hypoesthesia in the nerve VI area. He later developed pain in the arch of the eyebrow and diplopia. Five weeks later, two subcutaneous nodules appeared. Histology revealed a neuro-invasive epidermoid carcinoma explaining the clinical picture. Re-loading of the histological sections of the first injury confirmed the clearly differentiated invasive epidermoid carcinoma. However, renewed classified sections revealed neoplastic cells surrounding the nerve branches in the deep dermis. DISCUSSION Other than the extension through the blood or lymph circulation, epidermoid cutaneous cancers exhibit varying invasion of the nerve structures. Neurotropism is an aggressiveness marker. Only the pathologico-anatomic investigation enables an early diagnosis. In the case of recurrence, neurological symptomatology can precede skin injuries and make diagnosis difficult. The follow-up of the carriers of this type of tumor must include a neurological examination.
Collapse
Affiliation(s)
- D Waroquier
- Service de Dermatologie, Hôpital Erasme, Brussels, Belgium.
| | | | | | | | | |
Collapse
|
40
|
Kocak Z, Celik Y, Uzal MC, Uygun K, Kaya M, Albayram S. Isolated bilateral sixth nerve palsy secondary to metastatic carcinoma: a case report with a review of the literature. Clin Neurol Neurosurg 2004; 106:51-4. [PMID: 14643919 DOI: 10.1016/j.clineuro.2003.07.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Isolated sixth nerve palsies usually occur in the vasculopathic age group and are often associated with diabetes mellitus, hypertension, and atherosclerosis but also occur in the presence of skull base tumors. However, isolated bilateral sixth nerve palsies are an extremely rare complication of skull base lesions due to metastatic neoplasms. A case of a 46-year-old man with metastatic small-cell carcinoma of the lung that developed acute bilateral abducens nerve palsies is presented. Although this appears to be an isolated case, metastasis to the skull base must be included in the differential diagnosis of isolated bilateral sixth nerve palsies.
Collapse
Affiliation(s)
- Zafer Kocak
- Department of Radiation Oncology, Trakya Universitesi Hastanesi, Radyasyon Onkolojisi AbD, 22030 Edirne, Turkey.
| | | | | | | | | | | |
Collapse
|
41
|
Martin-Duverneuil N, Hourani R, Tankere F, Auriol M, Lamas G, Chiras J. Intracanalicular facial nerve metastasis presenting as a benign tumor in the internal auditory canal. Eur Radiol 2004; 14:1939-40. [PMID: 14986054 DOI: 10.1007/s00330-004-2251-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2003] [Revised: 12/22/2003] [Accepted: 01/09/2004] [Indexed: 10/26/2022]
|
42
|
Abstract
BACKGROUND Cranial nerve lesions due to metastases from prostate carcinoma to the skull base are an uncommon yet clinically significant finding. METHODS The authors report the clinical features, treatment, and outcomes for 15 patients who presented with cranial nerve palsies complicating metastatic prostate carcinoma. Patient charts identified from a Fox Chase Cancer Center treatment data base were reviewed. RESULTS All patients had hormone-refractory disease at the time of symptom onset. Twelve of 15 patients had received prior chemotherapy, and 13 of 15 patients had received prior radiation therapy to areas of bony pain. Symptoms varied from recognized clinical syndromes involving multiple cranial nerves to isolated cranial nerve lesions. All patients had lesions at the skull base that were visualized on computed tomography scans or magnetic resonance images. All patients were treated with palliative radiation therapy to either the whole brain or the skull base. Fourteen of 15 patients had a clinical (either partial or complete) response to radiation therapy. All responding patients subsequently died of prostate carcinoma without worsening of residual or development of new cranial nerve symptoms. Ten of 15 patients (67%) died within 3 months of developing symptoms, and the remaining 5 patients lived between 9 months and 31 months from onset of symptoms. CONCLUSIONS The authors concluded that palliative radiation therapy should be considered in this heterogeneous group of patients given the potential for significant symptom improvement.
Collapse
Affiliation(s)
- Raymond S McDermott
- Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA
| | | | | | | | | |
Collapse
|
43
|
Chang PC, Fischbein NJ, McCalmont TH, Kashani-Sabet M, Zettersten EM, Liu AY, Weissman JL. Perineural spread of malignant melanoma of the head and neck: clinical and imaging features. AJNR Am J Neuroradiol 2004; 25:5-11. [PMID: 14729519 PMCID: PMC7974186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
BACKGROUND AND PURPOSE Extension of malignant melanoma along cranial nerves is a little-known complication of malignant melanoma of the head and neck. We describe the clinical and MR imaging findings of perineural spread of malignant melanoma to cranial nerves, emphasizing that this entity occurs more commonly with desmoplastic histology and may have a long latent period following primary diagnosis. METHODS At two institutions, we identified and retrospectively reviewed eight cases of malignant melanoma of the head and neck that had MR imaging evidence of perineural spread of disease. All patients underwent confirmatory tissue sampling. RESULTS Seven patients had melanomas of the facial skin or lip, and one patient had a primary sinonasal lesion. By histopathology, these melanomas included five desmoplastic, two mucosal, and one poorly differentiated melanotic spindle-cell tumor. All patients developed symptomatic cranial neuropathy an average of 4.9 years from the time of initial diagnosis. MR imaging demonstrated postgadolinium enhancement of at least one branch of the trigeminal nerve in all cases and of at least one other cranial nerve in five cases. Other findings included abnormal contrast enhancement and soft tissue thickening in the cavernous sinus, Meckel's cave, and/or the cisternal segment of the trigeminal nerve. CONCLUSION Although perineural spread of disease occurs most commonly with squamous cell carcinoma and adenoid cystic carcinoma, malignant melanoma must also be included in this differential diagnosis, particularly if the patient's pathology is known to be desmoplastic. Similarly, any patient with malignant melanoma of the head and neck who undergoes MR imaging should receive an imaging assessment focused on the likely routes of perineural spread.
Collapse
Affiliation(s)
- Patrick C Chang
- Department of Radiology, University of California, San Francisco, School of Medicine, San Francisco, CA 94143, USA
| | | | | | | | | | | | | |
Collapse
|
44
|
Curtin HD. Detection of perineural spread: fat suppression versus no fat suppression. AJNR Am J Neuroradiol 2004; 25:1-3. [PMID: 14729517 PMCID: PMC7974180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
|
45
|
Fabre B, Gigaud M, Lamant L, Boulinguez S, Viraben R. [Trigeminal neuralgia presenting as a deep recurrent desmoplastic neurotropic melanoma of a lentigo maligna]. Ann Dermatol Venereol 2003; 130:1044-6. [PMID: 14724540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
INTRODUCTION Neurotropic melanoma is a particular anatomopathological form corresponding to dermal proliferation of desmoplastic cells of neuroid differentiation. We report a new case of neurotropic melanoma revealed by facial neuralgia. CASE REPORT A 64 year-old man presented in 1996 with a lentigo maligna on the right cheek treated by complete excision. After 2 years of medical supervision, a pigmented lesion recurred leading to new surgical treatment. The histological examination of the total lesion showed intra-epidermal atypical melanocyte proliferation without dermal invasion. In 1999, right trigeminal neuralgia occurred without associated cutaneous change. Cranial MRI revealed an infiltration of the right trigeminal nerve. Endo-buccal surgery disclosed a black swelling of the trigeminal nerve. Histological examination and immunohistochemistry revealed a desmoplastic melanoma. DISCUSSION Neurotropic melanoma with nerve invasion by malignant cells presenting as a trigeminal neuralgia is rare. Our case report underlined the depth of the neurotropic melanoma and the initial existence of a lentigo maligna without associated "neurotropic" melanoma.
Collapse
Affiliation(s)
- B Fabre
- Service de Dermatologie, Hôpital La Grave, Toulouse
| | | | | | | | | |
Collapse
|
46
|
Wang SJ, Hsu WC, Young YH. Reversible cochleo-vestibular deficits in two cases of jugular foramen tumor after surgery. Eur Arch Otorhinolaryngol 2003; 261:247-50. [PMID: 13680260 DOI: 10.1007/s00405-003-0666-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2003] [Accepted: 07/30/2003] [Indexed: 10/26/2022]
Abstract
Primary jugular foramen (JF) tumor, such as glomus jugular tumor or JF schwannoma, may manifest as a lower cranial nerve deficit; in addition, it can be accompanied by deafness or vertigo if it affects the cranial nerve (CN) VIII. Recently, we encountered JF schwannoma 1 and glomus jugulare tumor 1. Both cases invaded the adjacent cerebellopontine angle, leading to cochleo-vestibular deficits prior to the operation. After surgery, recovery of the audiovestibular function, including hearing, auditory brainstem response and caloric response, was anticipated in both patients. Therefore, cochleo-vestibular deficits in JF tumors can be attributed to compression neuropathy, rather than tumor infiltration.
Collapse
Affiliation(s)
- Shou-Jen Wang
- Department of Otolaryngology, National Taiwan University Hospital and College of Medicine, 1 Chang-Te Street, Taipei, Taiwan
| | | | | |
Collapse
|
47
|
Alvarez Suárez ML, Alvarez-Buylla Camino M, Barbón García JJ, Morís De La Tassa G, Pastor Hernández L. [Painful ophthalmoplegia secondary to larynx carcinoma]. Arch Soc Esp Oftalmol 2003; 78:43-6. [PMID: 12571774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
CASE REPORT We present a case of metastatic larynx cancer in the cavernous sinus. It presented itself as a right sixth cranial nerve palsy which progressed into a painful ophthalmoplegia with normal CT and RNM in its early stages. DISCUSSION We must suspect a cavernous sinus invasion in patients with cranial nerve palsies and with a history of malignancy, despite negative radiologic findings. Tumoral invasion of the skull base has been described in pharyngeal neoplasms but it is exceptional in larynx carcinomas.
Collapse
|
48
|
Ibáñez Flores N, Sanz Moreno S. [Bilateral neurotrophic keratitis secondary to encephalic trunk metastasis]. Arch Soc Esp Oftalmol 2002; 77:681-4. [PMID: 12471515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
CASE REPORT We report the case of a 69-year-old man with a lung carcinoma history. The patient showed signs of conjuntival hyperemia, painless bilateral corneal edema, persistent epitelial defects and reported to have decreasing visual acuity for a week. The clinical examination revealed a bilateral neurotrophyc keratitis with both a decreased frequency of blinking and a bilateral atrophy mandibular muscles. Local ocular patology was excluded. Systemic exploration showed a meningeal neoplasic infiltration and metastasis on the initial trigeminal nerve stretch. In our knowledge, this is the first case reported in the literature. DISCUSSION Ophthalmic signs should be considered in the diagnosis of systemic pathology.
Collapse
Affiliation(s)
- N Ibáñez Flores
- Servicio de Oftalmología del Hospital Príncipes de España (C.S.U.Bellvitge), Universidad Central de Barcelona, España.
| | | |
Collapse
|
49
|
Davis JL, Gilger BC, Spaulding K, Robertson ID, Jones SL. Nasal adenocarcinoma with diffuse metastases involving the orbit, cerebrum, and multiple cranial nerves in a horse. J Am Vet Med Assoc 2002; 221:1460-3, 1420. [PMID: 12458617 DOI: 10.2460/javma.2002.221.1460] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A 9-year-old Trakehner gelding was examined because of right exophthalmus. Clinical findings included a lack of menace response in the right eye, reduced direct and consensual right pupillary light reflexes, ventrolateral strabismus of the right eye, mild right-sided facial asymmetry, a head tilt to the left, and increased extensor tone in the right limbs. Findings were suggestive of a multifocal lesion affecting the right forebrain; right optic, oculomotor, and facial nerves; and left vestibulocochlear nerve. Ultrasonographic examination of the right eye revealed a vascular retrobulbar mass. Computed tomographic imaging revealed a mass that filled the nasal cavity and invaded the forebrain. Necropsy revealed an undifferentiated nasal adenocarcinoma affecting the orbit with metastases to the right parotid gland, cranial cervical lymph nodes, fascial planes of the neck, and lungs. No evidence of direct involvement of the right facial and left vestibulocochlear nerves was found, suggesting the possibility of paraneoplastic peripheral neuropathy.
Collapse
Affiliation(s)
- Jennifer L Davis
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA
| | | | | | | | | |
Collapse
|
50
|
Seitz J, Held P, Strotzer M, Völk M, Nitz WR, Dorenbeck U, Stamato S, Feuerbach S. MR imaging of cranial nerve lesions using six different high-resolution T1- and T2(*)-weighted 3D and 2D sequences. Acta Radiol 2002; 43:349-53. [PMID: 12225473 DOI: 10.1080/j.1600-0455.2002.430401.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
PURPOSE To find a suitable high-resolution MR protocol for the visualization of lesions of all 12 cranial nerves. MATERIAL AND METHODS Thirty-eight pathologically changed cranial nerves (17 patients) were studied with MR imaging at 1.5 T using 3D T2*-weighted CISS, T1-weighted 3D MP-RAGE (without and with i.v. contrast medium), T2-weighted 3D TSE, T2-weighted 2D TSE and T1-weighted fat saturation 2D TSE sequences. Visibility of the 38 lesions of the 12 cranial nerves in each sequence was evaluated by consensus of two radiologists using an evaluation scale from 1 (excellently visible) to 4 (not visible). RESULTS The 3D CISS sequence provided the best resolution of the cranial nerves and their lesions when surrounded by CSF. In nerves which were not surrounded by CSF, the 2D T1-weighted contrast-enhanced fat suppression technique was the best sequence. CONCLUSIONS A combination of 3D CISS, the 2D T1-weighted fat suppressed sequence and a 3D contrast-enhanced MP-RAGE proved to be the most useful sequence to visualize all lesions of the cranial nerves. For the determination of enhancement, an additional 3D MP-RAGE sequence without contrast medium is required. This sequence is also very sensitive for the detection of hemorrhage.
Collapse
Affiliation(s)
- J Seitz
- Department of Diagnostic Radiology, University Hospital, Regensburg, Germany, and Department of Radiology, Medical Center, University of California, San Diego, CA, USA
| | | | | | | | | | | | | | | |
Collapse
|