1
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Yao L, Feng M, Li XT, Gan WJ, Xu XT, Zhou YX. Clinical study of salivary gland malignant tumor with skull base metastasis. Br J Neurosurg 2024; 38:411-417. [PMID: 33641541 DOI: 10.1080/02688697.2021.1885616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 04/08/2020] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate the clinical performance, pathological characteristics, treatment and prognosis of salivary gland malignant tumor (SGMT) with skull base metastasis. METHODS Five SGMT patients with skull base metastasis were retrospectively studied. Major clinical symptoms included headache, facial paralysis, and ear hearing loss. Three patients had previous history of SGMT resection. All patients underwent preoperative computed tomography (CT) and magnetic resonance imaging (MRI). Craniotomy was performed in three patients, and all the five patients underwent radiotherapy and chemotherapy. RESULTS Two patients were confirmed as having adenocarcinoma, one patient was pathologically confirmed to have squamous cell carcinoma, one patient had ductal carcinoma, and one patient had acinar cell carcinoma. One patient died after 2 years of treatment, and the remaining 4 patients were followed up for 6 ∼ 24 months, suggesting that the tumor size was not enlarged or showed no local recurrence. CONCLUSION SGMT with skull base metastasis is extremely rare, and due to similar imaging characteristics, it can be easily misdiagnosed as meningioma or schwannoma. Early diagnosis, extent of invasion, surgery and combination of chemotherapy and radiotherapy are the prognostic factors of the disease.
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Affiliation(s)
- Lin Yao
- Department of Neurosurgery, The First Hospital Affiliated to SooChow University, Suzhou, Jiangsu, China
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu, Anhui, China
| | - Ming Feng
- Department of Neurosurgery, The First Hospital Affiliated to SooChow University, Suzhou, Jiangsu, China
| | - Xue-Tao Li
- Department of Neurosurgery, The First Hospital Affiliated to SooChow University, Suzhou, Jiangsu, China
| | - Wen-Juan Gan
- Department of Pathology, The First Hospital Affiliated to SooChow University, Suzhou, Jiangsu, China
| | - Xiao-Ting Xu
- Department of Radiotherapy, The First Hospital Affiliated to SooChow University, Suzhou, Jiangsu, China
| | - You-Xin Zhou
- Department of Neurosurgery and Brian and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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2
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Arivazhagan S, Parthiban GP, Busa V, Negulescu C. Occipital Condyle Syndrome As the Initial Presentation of Recurrence of Metastatic Breast Cancer: A Case Report. Cureus 2023; 15:e34567. [PMID: 36883096 PMCID: PMC9985513 DOI: 10.7759/cureus.34567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2023] [Indexed: 02/05/2023] Open
Abstract
Skull-base metastasis is extremely rare. Various syndromes have been identified based on the anatomical involvement of the metastatic tumor. Occipital condyle syndrome (OCS) occurs with involvement of occipital bone and compression of the hypoglossal canal. OCS is very rare and usually has an underlying widely disseminated metastatic cancer. We present a 66-year-old female who initially presented with tongue deviation and occipital headache. MRI revealed a mass compressing the occipital bone and hypoglossal canal. Further work-up revealed metastatic breast cancer.
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Affiliation(s)
| | | | - Vishal Busa
- Internal Medicine, Baton Rouge General, Baton Rouge, USA
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3
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Kim K, Lee J, Seong J. Skull Base Metastasis from Hepatocellular Carcinoma: Clinical Presentation and Efficacy of Radiotherapy. J Hepatocell Carcinoma 2022; 9:357-366. [PMID: 35520947 PMCID: PMC9064478 DOI: 10.2147/jhc.s361045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/21/2022] [Indexed: 01/22/2023] Open
Abstract
Purpose Skull base metastasis (SBM) from hepatocellular carcinoma (HCC) presents detrimental survival outcomes with cranial nerve symptoms; however, they have received little attention. This study aimed to investigate the clinical presentation and efficacy of radiation therapy (RT) in patients with SBM from HCC. Patients and Methods We identified patients with SBM from HCC in Yonsei Cancer Center from 2005 to 2019. Image evaluations and SBM-related symptoms were reviewed. Overall survival was calculated using the Kaplan–Meier method and compared through the Log rank test. The oligometastasis group included patients with less than five foci of tumors, while the extensive metastasis group presented five or more sites. Results The incidence of SBM from HCC was 1.5% (58/3793 patients), commonly found in the middle cranial fossa. SBM associated symptoms presented in 51 patients, and the most common were head and neck area pain, and orbital symptoms, The palliation rate after RT was 65% (24/39 patients) for overall symptoms and 83.3% (20/24 patients) for cranial nerve symptoms. In whole cohort, overall survival was analyzed, and the median overall survival of patients with oligometastasis was better than extensive metastasis (23.7 months vs 1.8 months, p < 0.001). In subgroup who received RT (39 patients), the median overall survival was 23.7 and 2.7 months for patients with oligo and extensive metastasis, respectively (p < 0.001). Conclusion This study confirmed clinical features of SBM from HCC. Overall survival was generally poor, but patients presenting oligometastasis seemed to have possibility of relative long-term survival. Although radiation was effective in SBM-induced symptom relief, dose–response relationship in local control rate and overall survival needs further studies with larger number of patients.
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Affiliation(s)
- Kangpyo Kim
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Joongyo Lee
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jinsil Seong
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea
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4
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Yasumizu Y, Kosaka T, Hongo H, Mizuno R, Oya M. Cranial nerve palsy caused by metastasis to the skull base in patients with castration-resistant prostate cancer: Three case reports. IJU Case Rep 2021; 4:108-111. [PMID: 33718819 PMCID: PMC7924080 DOI: 10.1002/iju5.12255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/19/2020] [Accepted: 12/25/2020] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Skull base metastasis of prostate cancer associated with cranial nerve palsy is rare. We observed three patients with aggressive prostate cancer who experienced cranial nerve palsy. CASE PRESENTATION Case 1 was a 53-year-old patient who was treated with carboplatin and etoposide. He noticed sensory abnormalities on his left mouth edge. Head magnetic resonance imaging revealed skull base metastasis. Case 2 was a 50-year-old patient who received docetaxel. This patient exhibited ptosis of the left eye. Skull base metastasis was detected by magnetic resonance imaging. External beam radiation therapy was performed. Case 3 was a 64-year-old patient who was treated with docetaxel. He experienced ptosis of the right eye and diplopia. He was also treated with external beam radiation therapy. CONCLUSION External beam radiation therapy exhibited some efficacy against the symptoms, but skull base metastasis of treatment-resistant prostate cancer has poor prognosis. Three patients died within 3 months after symptoms occurred with or without external beam radiation therapy.
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Affiliation(s)
- Yota Yasumizu
- Department of UrologyKeio University School of MedicineTokyoJapan
| | - Takeo Kosaka
- Department of UrologyKeio University School of MedicineTokyoJapan
| | - Hiroshi Hongo
- Department of UrologyKeio University School of MedicineTokyoJapan
| | - Ryuichi Mizuno
- Department of UrologyKeio University School of MedicineTokyoJapan
| | - Mototsugu Oya
- Department of UrologyKeio University School of MedicineTokyoJapan
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5
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Adachi K, Maeda Y, Hayama M, Kitaguchi Y, Nojima S, Nitta K, Obata S, Nakatani A, Tsuda T, Takeda K, Morii E, Inohara H. Skull Base Metastasis of Breast Cancer With Oculomotor and Trochlear Nerve Palsy. Ear Nose Throat J 2020; 101:NP270-NP272. [PMID: 33035131 DOI: 10.1177/0145561320963676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Skull base metastatic tumors are rare. Breast cancer in particular can cause bone metastases after a long period of time. A 70-year-old woman presented with multiple cranial nerve palsy. Magnetic resonance imaging revealed a lesion that extended from the orbit to the base of the skull, and the patient was referred to our department. Ophthalmological evaluation showed left visual acuity impairment, left oculomotor nerve palsy, and left trochlear nerve palsy. Endoscopic biopsy performed 5 years after the completion of breast cancer treatment revealed skull base metastases. In unilateral multiple cranial nerve palsy, the possibility of skull base metastases should be considered.
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Affiliation(s)
- Kana Adachi
- Department of Otorhinolaryngology-Head and Neck Surgery, 13013Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yohei Maeda
- Department of Otorhinolaryngology-Head and Neck Surgery, 13013Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masaki Hayama
- Department of Otorhinolaryngology-Head and Neck Surgery, 13013Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshiyuki Kitaguchi
- Department of Ophthalmology, 13013Osaka University Graduate School of Medicine, Osaka, Japan
| | - Satoshi Nojima
- Department of Pathology, 13013Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kanae Nitta
- Department of Surgery, Otemae Hospital, Osaka, Japan
| | - Sho Obata
- Department of Otorhinolaryngology-Head and Neck Surgery, 13013Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ayaka Nakatani
- Department of Otorhinolaryngology-Head and Neck Surgery, 13013Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takeshi Tsuda
- Department of Otorhinolaryngology-Head and Neck Surgery, 13013Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazuya Takeda
- Department of Otorhinolaryngology-Head and Neck Surgery, 13013Osaka University Graduate School of Medicine, Osaka, Japan
| | - Eiichi Morii
- Department of Pathology, 13013Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hidenori Inohara
- Department of Otorhinolaryngology-Head and Neck Surgery, 13013Osaka University Graduate School of Medicine, Osaka, Japan
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6
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Miyazaki S, Harada Y, Sasaki Y, Fukushima T. CyberKnife Radiotherapy for Skull Base Petroclival Metastases Including Dorello's Canal: Report of 10 Cases. Cureus 2020; 12:e10692. [PMID: 33133857 PMCID: PMC7593206 DOI: 10.7759/cureus.10692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Skull base petroclival metastases cause diplopia due to abducens nerve palsy. Diplopia is visually disabling, and skull base metastasis is extremely difficult to treat even with microscopic surgery. However, stereotactic radiotherapy with CyberKnife (Accuray Incorporated, Sunnyvale, California) has been very successful in 10 cases. As the abducens nerve runs through Dorello’s canal in the skull base, the radiation dose and fraction were adjusted to avoid damage to the nerve. Since these metastases are not located inside the brain but in the skull base, contrast magnetic resonance imaging (MRI) combined with fluorodeoxyglucose-positron emission tomography (FDG-PET) was essential to detect the cancers.
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Affiliation(s)
| | - Yuko Harada
- CyberKnife Center, Shin-Yurigaoka General Hospital, Kawasaki, JPN
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7
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Zhai Z, Hu J, You Y, Yang X, Song Z. Tumor with slow-developing and recurring lumps of the external ear with skull base and lung metastasis: A case report. Oncol Lett 2020; 20:1567-1572. [PMID: 32724398 PMCID: PMC7377094 DOI: 10.3892/ol.2020.11724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 04/15/2020] [Indexed: 11/06/2022] Open
Abstract
The present case report describes a rare case of recurring lumps on the external ear in a 46-year-old Chinese male with a history of >10 years, who presented with large irregular red lumps on the right temple and with lung and skull base metastasis. The patient had a lesion in the right auricle and experienced recurrence following surgical resection. A thorough systemic evaluation revealed no other obvious abnormalities. The patient was diagnosed with adenoid cystic carcinoma (ACC), a slow-growing form of high-grade adenocarcinoma, and refused any further treatment at the present hospital (The First Affiliated Hospital of Army Medical University). At 2 years post-follow-up, the patient had become more frail but was in good spirits. The present study indicated that ACC is a low-grade and commonly slow-developing malignancy that primarily arises from a salivary gland, with recurring and metastatic characteristics.
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Affiliation(s)
- Zhifang Zhai
- Department of Dermatology, The First Affiliated Hospital, Army Medical University, Chongqing 400038, P.R. China
| | - Jie Hu
- Department of Dermatology, The First Affiliated Hospital, Zunyi Medical College, Zunyi, Guizhou 563003, P.R. China
| | - Yi You
- Department of Dermatology, The First Affiliated Hospital, Army Medical University, Chongqing 400038, P.R. China
| | - Xichuan Yang
- Department of Dermatology, The First Affiliated Hospital, Army Medical University, Chongqing 400038, P.R. China
| | - Zhiqiang Song
- Department of Dermatology, The First Affiliated Hospital, Army Medical University, Chongqing 400038, P.R. China
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8
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Stamates MM, Lee JM, Merrell RT, Shinners MJ, Wong RH. Combined Open and Endoscopic Endonasal Skull Base Resection of a Rare Endometrial Carcinoma Metastasis. J Neurol Surg Rep 2018; 79:e9-e13. [PMID: 29479514 PMCID: PMC5823696 DOI: 10.1055/s-0038-1635098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 01/12/2018] [Indexed: 11/25/2022] Open
Abstract
In the absence of significant extracranial disease, patients with solitary brain metastases have shown benefit with resection. Brain lesions due to endometrial cancer are uncommon, and the only described skull base involvement is limited to the pituitary gland. We report the case of a 60-year-old female with endometrial cancer who presented with weeks of right cheek pain and numbness that was accompanied by headaches. We describe the magnetic resonance imaging (MRI) findings and surgical resection of a solitary endometrial metastasis involving the infratemporal fossa, middle fossa, cavernous sinus, trigeminal nerve, and nasal sinuses. Due to extensive nasal and lateral involvement, a combined open and endoscopic approach was planned. The patient was discharged home without complication. She underwent adjuvant radiotherapy. Despite its suspected indolent course, intracranial endometrial adenocarcinoma metastases are gaining higher prevalence. This case report documents the first direct neural spread of an endometrial primary, and highlights the potential for extra-axial sites of metastasis.
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Affiliation(s)
- Melissa M Stamates
- Section of Neurosurgery, University of Chicago, Chicago, Illinois, United States
| | - John M Lee
- Department of Pathology and Laboratory Medicine, NorthShore University Health System, Evanston, Illinois, United States
| | - Ryan T Merrell
- Department of Neurology, NorthShore University Health System, Evanston, Illinois, United States
| | - Michael J Shinners
- Department of Otolaryngology, NorthShore University Health System, Evanston, Illinois, United States
| | - Ricky H Wong
- Department of Neurosurgery, NorthShore University Health System, Evanston, Illinois, United States
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9
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Katsanos AH, Sioka C, Chondrogiorgi M, Papadopoulos A, Fotopoulos A, Kyritsis AP, Ragos V. Skull Base Metastasis Revealed by Bone Scintigraphy in a Patient With Hypoglossal Nerve Palsy. Neurohospitalist 2018; 8:188-190. [PMID: 30245769 DOI: 10.1177/1941874418755952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Even though different imaging modalities are available in sole or in combination for the optimal detection of bone metastases, whole-body bone scintigraphy (BS) in a single session seems to be advantageous. We present an 80-year-old male with unilateral left hypoglossal nerve palsy (HNP) and no other focal deficits on neurological examination. Initial brain computed tomography (CT) scan revealed no pathological findings, while the subsequent cranial CT and magnetic resonance imaging (MRI) scans uncovered only mild nonspecific sclerotic lesions in left occipital condyle. All laboratory examinations were within normal limits, except for an elevated alkaline phosphatase (170 U/L) and a markedly increased prostate-specific antigen (609 ng/mL). The patient underwent whole-body BS with technetium-99m that revealed increased radiotracer deposition compatible with metastases in multiple foci, including the left occipital condyle. Prostate biopsy confirmed the diagnosis of prostate adenocarcinoma. Our case suggests that a complete and thorough workup for hidden malignancies should be performed in all patients with HNP, even in the absence of a finding in brain neuroimaging. Bone scintigraphy is an essential investigation that should be considered in uncertain cases of HNP, and especially in those with negative CT and MRI scans.
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Affiliation(s)
- Aristeidis H Katsanos
- Department of Neurology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Chrissa Sioka
- Department of Nuclear Medicine, University of Ioannina School of Medicine, Ioannina, Greece.,Neurosurgical Research Institute, University of Ioannina School of Medicine, Ioannina, Greece
| | - Maria Chondrogiorgi
- Department of Neurology, University of Ioannina School of Medicine, Ioannina, Greece
| | | | - Andreas Fotopoulos
- Department of Nuclear Medicine, University of Ioannina School of Medicine, Ioannina, Greece
| | - Athanassios P Kyritsis
- Department of Neurology, University of Ioannina School of Medicine, Ioannina, Greece.,Neurosurgical Research Institute, University of Ioannina School of Medicine, Ioannina, Greece
| | - Vasileios Ragos
- Department of Maxillofacial Surgery, University of Ioannina School of Medicine, Ioannina, Greece
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10
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Machío Castelló M, Escobar Montatixe D, Cenjor Español C, Villacampa Aubá JM, Montoya Bordón J, Carias Calix R, Sáez Pinel R. Incomplete cavernous sinus syndrome as the initial manifestation of a previously undetected metastatic prostate adenocarcinoma. Head Neck 2017; 39:E77-E80. [PMID: 28474478 DOI: 10.1002/hed.24808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 02/14/2017] [Accepted: 03/14/2017] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Cavernous sinus syndrome presents as unilateral ophthalmoplegia associated with sympathetic denervation, pain, paresthesias, and V1 and V2 distribution numbness. The etiology may be vascular, inflammatory, infectious, and, less commonly, neoplastic (metastatic). METHODS We report a patient with incomplete cavernous sinus syndrome as the initial manifestation of previously undetected metastatic prostate adenocarcinoma. RESULTS A 59-year-old man presented with a 2-month history of left hemicranial headaches with ptosis and binocular diplopia. Clinical evaluation found left third, fourth, and sixth cranial nerve palsy with mydriasis and ptosis. An MRI showed an enhancing lesion at the clivus with infiltration of left cavernous sinus. A trans-sphenoidal biopsy was performed, leading to diagnosis of metastatic prostate adenocarcinoma. The patient underwent treatment and achieved clinical improvement. CONCLUSIONS In middle-aged men, it is important to include metastatic prostate adenocarcinoma in the differential diagnosis of cavernous sinus syndrome, even in the absence of primary tumor diagnosis.
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Affiliation(s)
- María Machío Castelló
- Department of Neurology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Diego Escobar Montatixe
- Department of Otolaryngology, Head and Neck Surgery, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Carlos Cenjor Español
- Department of Otolaryngology, Head and Neck Surgery, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - José Miguel Villacampa Aubá
- Department of Otolaryngology, Head and Neck Surgery, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Julia Montoya Bordón
- Department of Neurology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Rafael Carias Calix
- Department of Pathology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Rafael Sáez Pinel
- Department of Neurology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
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11
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Erkan S, Somner J, Rajan GP. Sunitinib as Neoadjuvant Chemotherapy in the Management of Metastatic Renal Cell Carcinoma Mimicking a Glomus Vagale Tumor in the Head and Neck: A Case Report and Review of Literature. J Neurol Surg Rep 2016; 77:e77-82. [PMID: 27247912 PMCID: PMC4882188 DOI: 10.1055/s-0036-1579629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background Metastatic renal cell carcinoma (RCC) of the head and neck with intracranial extension is rare and may pose difficulties to the diagnosis and management. Method We describe a unique case of a 76-year-old man with a metastatic RCC to the neck and lateral skull base with intracranial extension presenting with Collet-Sicard syndrome 8 years after initial diagnosis. The radiologic features were consistent with the diagnosis of a glomus vagale tumor on the basis of clinical and radiologic features. Results Despite radiotherapy, the intracranial extension progressed in size, resulting in early hydrocephalus. Sunitinib, a novel tyrosine kinase inhibitor, was instituted to treat the glomus vagale tumor with a marked reduction in tumor volume and resolution of the early hydrocephalus. The surgical resection of the tumor with its intracranial extension was achieved without additional postoperative morbidity. The histopathologic diagnosis surprisingly demonstrated metastatic RCC. Conclusion We present a case of metastatic RCC to the head and neck region mimicking a glomus vagale tumor and describe the first use of sunitinib as a neoadjuvant chemotherapy to achieve a single-stage radical en bloc resection of the tumor mass.
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Affiliation(s)
- Serkan Erkan
- Department of Otolaryngology, Head and Neck Surgery, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Jessica Somner
- Department of Otolaryngology, Head and Neck Surgery, University of Western Australia, Nedlands, Western Australia, Australia
| | - Gunesh P Rajan
- Department of Otolaryngology, Head and Neck Surgery, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Department of Otolaryngology, Head and Neck Surgery, School of Surgery, University of Western Australia, Murdoch, Western Australia, Australia
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12
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Abstract
Skull base metastasis from differentiated thyroid carcinoma, including papillary and follicular thyroid carcinoma, is a rare manifestation. Herein, we present three cases of skull base metastasis of papillary thyroid carcinoma. The mean age of the patients was 68.6 (65–74) years, and the mean interval between initial diagnosis and skull base metastasis was 56.3 (28–89) months. Cranial nerve palsies were seen in all patients. Intensity modulated radiation therapy to deliver 6,000–6,600 cGy to the skull base metastasis was given to all patients, in addition to partial resection in one patient. At the time of last follow-up, all skull base metastases were well controlled.
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Affiliation(s)
- Mutahir A Tunio
- Radiation Oncology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mushabbab Al Asiri
- Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Khalid Hussain Al-Qahtani
- Department of Otolaryngology -Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Sadiq Aldandan
- Department of Histopathology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Khalid Riaz
- Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Yasser Bayoumi
- Radiation Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
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13
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Matsuno A, Murakami M, Hoya K, M. Yamada S, Miyamoto S, Yamada S, Son JH, Nishido H, Ide F, Nagashima H, Sugaya M, Hirohata T, Mizutani A, Okinaga H, Ishii Y, Tahara S, Teramoto A, Osamura RY, Yamazaki K, Ishida Y. Clinicopathological and molecular histochemical review of skull base metastasis from differentiated thyroid carcinoma. Acta Histochem Cytochem 2013; 46:129-36. [PMID: 24194626 PMCID: PMC3813819 DOI: 10.1267/ahc.13019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 10/03/2013] [Indexed: 02/02/2023] Open
Abstract
Skull base metastasis from differentiated thyroid carcinoma including follicular thyroid carcinoma (FTC) and papillary thyroid carcinoma (PTC) is a rare clinical entity. Eighteen FTC cases and 10 PTC cases showing skull base metastasis have been reported. The most common symptom of skull base metastasis from FTC and PTC is cranial nerve dysfunction. Bone destruction and local invasion to the surrounding soft tissues are common on radiological imaging. Skull base metastases can be the initial clinical presentation of FTC and PTC in the presence of silent primary sites. The possibility of skull base metastasis from FTC and PTC should be considered in patients with the clinical symptoms of cranial nerve dysfunction and radiological findings of bone destruction. A variety of genetic alterations in thyroid tumors have been identified to have a fundamental role in their tumorigenesis. Molecular histochemical studies are useful for elucidating the histopathological features of thyroid carcinoma. Recent molecular findings may provide novel molecular-based treatment strategies for thyroid carcinoma.
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Affiliation(s)
- Akira Matsuno
- Department of Neurosurgery, Teikyo University Chiba Medical Center
| | - Mineko Murakami
- Department of Neurosurgery, Teikyo University Chiba Medical Center
| | - Katsumi Hoya
- Department of Neurosurgery, Teikyo University Chiba Medical Center
| | - Shoko M. Yamada
- Department of Neurosurgery, Teikyo University Chiba Medical Center
| | - Shinya Miyamoto
- Department of Neurosurgery, Teikyo University Chiba Medical Center
| | - So Yamada
- Department of Neurosurgery, Teikyo University Chiba Medical Center
| | - Jae-Hyun Son
- Department of Neurosurgery, Teikyo University Chiba Medical Center
| | - Hajime Nishido
- Department of Neurosurgery, Teikyo University Chiba Medical Center
| | - Fuyuaki Ide
- Department of Neurosurgery, Teikyo University Chiba Medical Center
| | | | - Mutsumi Sugaya
- Department of Rehabilitation, Teikyo University Chiba Medical Center
| | - Toshio Hirohata
- Department of Neurosurgery, Teikyo University Chiba Medical Center
- Department of Neurosurgery, The University of Tokyo
| | - Akiko Mizutani
- Department of Neurosurgery, Teikyo University Chiba Medical Center
- Teikyo Heisei University
| | | | - Yudo Ishii
- Department of Neurosurgery, Nippon Medical School
| | | | | | - R. Yoshiyuki Osamura
- Department of Pathology, International University of Health and Welfare Mita Hospital
| | - Kazuto Yamazaki
- Department of Pathology, Teikyo University Chiba Medical Center
| | - Yasuo Ishida
- Department of Pathology, Teikyo University Chiba Medical Center
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Hayward D, Morgan C, Emami B, Biller J, Prabhu VC. Jugular foramen syndrome as initial presentation of metastatic lung cancer. J Neurol Surg Rep 2012; 73:14-8. [PMID: 23946920 PMCID: PMC3658657 DOI: 10.1055/s-0032-1301406] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 09/23/2011] [Indexed: 10/27/2022] Open
Abstract
Metastatic involvement of the cranial base and jugular foramen generally presents with headache and lower cranial neuropathy but may escape early diagnosis. In this report, a patient developed a jugular foramen syndrome as the initial presentation of metastatic lung cancer soon after being diagnosed and treated surgically for extracranial atherosclerotic internal carotid artery disease. With the appropriate diagnosis established, he underwent local fractionated radiation therapy and systemic chemotherapy but succumbed to the disease. This report analyses metastatic disease affecting the cranial base and in particular, the jugular foramen, with a discussion of the clinical syndromes that accompany this rare condition.
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Affiliation(s)
- Dustin Hayward
- Department of Neurological Surgery, Loyola University Medical Center, Maywood, Illinois
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