Cranial Neuropathy as a Presenting Sign of Recurrent Aggressive Skin Cancer

Abstract

Cranial neuropathy is a rare presentation of recurrent cutaneous neoplasms of the head and neck. Given this infrequent occurrence and shared features of presentation, these highly morbid tumors are often mistakenly diagnosed as Bell's palsy or trigeminal neuralgia. Our findings corroborate previous reports of diagnostic delay, increased tumor burden, and worsened morbidity and mortality associated with such cutaneous malignancies. The critical utility of radiologic imaging for staging and tumor delineation are also supported by our institutional data.

Spider peptide Phα1β induces analgesic effect in a model of cancer pain

“…Although pain is not a major symptom of melanoma in the clinic, 7% of patients experienced pain; metastatic melanoma is associated with excruciating pain, and more than 50% of these patients require palliative care and morphine treatment . Here, we observed that all mice inoculated with melanoma cells presented hyperalgesia 14 days after inoculation.…”

“…Although pain is not a major symptom of melanoma in the clinic, 7% of patients experienced pain; metastatic melanoma is associated with excruciating pain, and more than 50% of these patients require palliative care and morphine treatment. (20,21) Here, we observed that all mice inoculated with melanoma cells presented hyperalgesia 14 days after inoculation. This type of pain was seen in both inoculated (ipsilateral) and noninnoculated (contralateral) hind-paw of mice, indicating a further site than the primary tumor (50% PWT values of 1.974 AE 0.351 g and 2.197 AE 0.381 g at baseline or 0.053 AE 0.011 g and 0.417 AE 0.134 g, for the ipsilateral and contralateral paw, respectively; P < 0.001, Student's t-test, n = 8-10).…”

Multifocal radiculoneuropathy during ipilimumab treatment of melanoma

“…Melanoma‐associated remote polyneuropathies are rare. Most melanoma‐related peripheral nerve involvement is due to direct spread or leptomeningeal melanoma, which were unlikely in our patient, who had 2 negative CSF cytology studies and gradual improvement of his syndrome after immunotherapy.…”

Facial pain and multiple cranial palsies in a patient with skin cancer

“…Multiple cranial neuropathies as an initial symptom of recurrent neoplasm have been reported in few studies. The latest study by Leach et al [1] reported multiple cranial nerve involvement in 67% (4 out of 6 patients) of the patient in comparison to 21% (13 out of 62 patients) found in a study of Mendenhall et al [2]. Facial pain, progressive weakness of the facial nerve and involvement of fifth cranial nerve were the symptoms most often referred by the patients in previous studies [1–5].…”