Garcin syndrome caused by parotid gland adenoid cystic carcinoma

Abstract

Rationale:Garcin syndrome is characterized by the gradual involvement, and ultimately, unilateral paralysis of at least 7 and sometimes all cranial nerves, without intracranial hypertension or any long tract signs.Patient concerns:We report the case of a 59-year-old woman who presented with Garcin syndrome, which gradually progressed over a period of 2 years.Diagnosis:A left parotid gland biopsy revealed parotid gland adenoid cystic carcinoma (PGACC) with perineural invasion of a peripheral nerve bundle and lymph node metastasis.Interventions:The patient was treated 3 times with local-field palliative radiotherapy.Outcomes:She died after several months.Lessons:To the best of our knowledge, this is the first report of PGACC presenting as Garcin syndrome. PGACC is a rare tumor with a high propensity for perineural spread, and it should be considered as a possible cause of Garcin syndrome.

Multiple cranial neuropathies secondary to adenoid cystic carcinoma of the parotid gland

“…There have been several reports of polyneuropathy leading to Garcin's syndrome associated with ACC. [2][3][4] In a report of a submandibular gland primary ACC with Garcin's syndrome, although brain MRI images showed no cranial nerve abnormalities, the disease progression was speculated to have begun with tumor cells invading the sympathetic plexus around the submandibular gland and the nearby internal carotid artery, extending to the cavernous sinus, invading cranial nerves III-VI, and invading the glossopharyngeal and vagus nerves from the anastomotic network between the trigeminal and sympathetic nerves. 2 As reported in the present study, there are anatomical network formations in the cranial nerves and their branches.…”