Delayed diagnosis of cranial neuropathies from perineural spread of skin cancer
| Autor: | Daniel G Nelson, Valérie Biousse, Gregory J. Esper, Samuel Bidot, Nancy J. Newman |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
squamous cell carcinoma medicine.medical_specialty Perineural invasion Autopsy Case Report Cranial neuropathy 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid Neuroimaging lcsh:Ophthalmology medicine Trigeminal nerve Palsy business.industry Cranial nerves Foramen ovale (skull) perineural invasion Ophthalmology 030104 developmental biology medicine.anatomical_structure lcsh:RE1-994 030221 ophthalmology & optometry perineural spread Radiology business |
| Zdroj: | Taiwan Journal of Ophthalmology Taiwan Journal of Ophthalmology, Vol 11, Iss 1, Pp 86-88 (2021) |
| ISSN: | 2211-5072 2211-5056 |
| Popis: | Perineural spread (PNS) to cranial nerves (CNs) by cutaneous malignancies is difficult to diagnose given the indolent course and often late or absent findings on brain imaging. A 68-year-old white man with multiple cranial neuropathies secondary to PNS by squamous cell carcinoma had negative high-quality neuroimaging for 5.25 years. He first developed left facial numbness, followed 39 months later by a left CN VI palsy. Subsequent examinations over 2 years showed involvement of left seventh, right trigeminal V1-V3, and right sixth, and bilateral third nerve palsies. Repeat high-quality brain magnetic resonance imaging (MRIs) during this time showed no identifiable CNs abnormality. Full body positron emission tomography imaging and cerebrospinal fluid studies were normal. 5.25 years after initial sensory symptom onset, MRI showed new enhancement along the right mandibular branch of the trigeminal nerve with foramen ovale widening. Autopsy showed squamous cell carcinoma within both CNs sixth. A long interval to diagnosis of PNS is associated with high morbidity, emphasizing the need for earlier methods of detection when clinical suspicion is high. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|