Metastasis to the base of the skulk clinical findings in 43 patients

Greenberg, Harry S.; Deck, Michael D. F.; Bhatia, Vikram; Chu, Florence C. H.; Posner, Jerome B.

doi:10.1212/wnl.31.5.530

Cited by 292 publications

(159 citation statements)

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“…2,3 In some instances, the presentation may be confusing and mimic a cerebrovascular, infectious, or metabolic affliction. Greenberg et al 4 described cranial dysfunction syndromes caused by skull base metastases. These include Collet-Siccard syndrome, 5 which is a palsy of the lower four cranial nerves; Villaret syndrome, 6 which is a palsy of the lower four cranial nerves with ipsilateral Horner syndrome; Occipital condyle syndrome, 7 which consists of unilateral occipital pain with ipsilateral 12 th nerve paresis; Jugular foramen syndrome 8 with dysphagia and neck pain; Parasellar syndrome 9 with extra ocular palsy and isolated 3rd, 6th or 7th cranial nerve palsies.…”

Section: Discussionmentioning

confidence: 99%

Collet Siccard Syndrome without skull base metastasis : A rare presentation of bronchogenic adenocarcinoma

Shetty¹,

Ramaprakasha²,

Alex³

et al. 2013

Int J of Biomed & Adv Res

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A 54 year old female on evaluation of dysarthria was found to have left IX, X and XII cranial nerve palsy. General physical examination revealed bilateral cervical level V multiple lymph nodes which were firm to hard and non-tender; respiratory system examination suggested left sided mild pleural effusion. MRI brain and cervical spine did not show any evidence of meningeal enhancement or skull base metastasis. Bronchoscopy revealed a mass lesion in left main bronchus. Her cranial nerve symptoms were attributed to Collet-Sicard syndrome because of the lymph node metastasis from lung cancer. It is a rare case of Collet-Sicard syndrome resulting from lymph node metastasis of adenocarcinoma of lung and is important as a differential diagnosis of lower cranial nerve palsy.

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Section: Discussionmentioning

confidence: 99%

Collet Siccard Syndrome without skull base metastasis : A rare presentation of bronchogenic adenocarcinoma

Shetty¹,

Ramaprakasha²,

Alex³

et al. 2013

Int J of Biomed & Adv Res

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“…In a study of skull base metastasis caused by various malignancies, radiological confirmation of metastatic spread to the skull base was found in only 77% of patients. 8 It was reported that bone scintigraphy was the most sensitive method for investigation. 9 Bone scintigraphy, however, cannot clearly show the localization of the metastasis.…”

Section: Discussionmentioning

confidence: 99%

Cranial nerve deficit caused by skull metastasis of prostate cancer: three Japanese castration-resistant prostate cancer cases

et al. 2010

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We report 3 Japanese patients with cranial nerve deficit caused by skull metastasis of prostate cancer (PCa). Case 1 was a 75-year-old patient with a chief complaint of diplopia. The cause of diplopia was right oculomotor nerve palsy from the skull metastasis. External beam radiation therapy (EBRT) to the whole brain, 40 Gy in 20 fractions, was performed and the diplopia improved. Case 2 was a 72-year-old patient with a chief complaint of facioplegia. Bone scintigraphy and computed tomography (CT) of the head revealed right occipital bone metastasis of PCa resulting in right facial nerve palsy. EBRT to the right occipital bone, 50 Gy in 25 fractions, with daily oral dexamethasone (DEX) was performed and facioplegia showed complete recovery.At 12 months after onset, the patient was followed with no symptoms. Case 3 was a 74-year-old patient with a chief complaint of diplopia. Diffusion weighted magnetic resonance imaging (MRI) and positron emission tomography (PET) showed right petrous bone metastasis resulting in right abducent nerve palsy. EBRT to the right petrous bone, 44 Gy in 22 fractions, with oral DEX was performed and diplopia showed complete recovery. At 13 months after onset, the patient was followed with no symptoms. MRI and PET may detect PCa metastasis in the skull base more clearly than other imaging modalities. EBRT with 40 -50 Gy in 20 -25 fractions in association with corticosteroid administration may be a reasonable treatment modality in the treatment of patients with metastatic PCa who develop cranial nerve dysfunction.

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“…36 Prostate cancer metastasizes primarily to lymph node and bone with 90% involving the spine, but also to lung in 50%, liver in 25%, and brain much less often and only after an average of 5 years of active disease. 7 In total, only about 4% of all cancers will metastasize to the base of the skull, 12 and while prostate cancer is the primary contributor, at 38.5% per one extensive review of 279 cases in the literature, 37 it rarely affects the cavernous sinus causing CSS. 12 Regardless, prognosis is poor with estimates of median survival of 1 year with skull base metastasis and only 5 months if CNs are affected.…”

Section: Noted Complete Cn III Iv Vi Palsies Of the Right Side Sevmentioning

confidence: 99%

“…7 In total, only about 4% of all cancers will metastasize to the base of the skull, 12 and while prostate cancer is the primary contributor, at 38.5% per one extensive review of 279 cases in the literature, 37 it rarely affects the cavernous sinus causing CSS. 12 Regardless, prognosis is poor with estimates of median survival of 1 year with skull base metastasis and only 5 months if CNs are affected. 11 Despite its rarity, the morbidity associated with CSS mandates a thorough evaluation.…”

Section: Noted Complete Cn III Iv Vi Palsies Of the Right Side Sevmentioning

confidence: 99%

“…However, while our review of the literature shows a few hundred cases of CSS reported, there are only a handful of cases that describe invasion of prostate cancer metastases into the cavernous sinus, specifically which are summarized in Table 1. [12][13][14][15][17][18][19][20][21][22] Prostate metastases to other regions of the skull base, such as the sphenoid sinus, clivus, or petrous bone, with various neuropathies have been described in just a Abir.…”

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confidence: 99%

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Metastatic Prostate Cancer Manifesting as Cavernous Sinus Syndrome—Case Report and Review of the Literature

Kuiper¹,

Babikian²,

Delacruz³

2017

Oncology &Amp; Hematology Review (US)

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C avernous sinus syndrome (CSS) is a rare clinical entity which results in compression of the neurovascular structures in the cavernous sinus, potentially leading to headache, ophthalmoplegia, and neuropathy. The most common causes are tumor, trauma, inflammation, aneurysm, and infection. We report the case of an 82-year-old male with osseous-predominant metastatic prostate cancer who was admitted for intractable right-sided periorbital pain and diplopia. He also developed a headache with associated mild ptosis and weak cranial nerve (CN) VI function. He later developed complete right eye ptosis, complete CN VI paralysis, and palsies of CNs III and IV. Magnetic resonance imaging (MRI) of the sella turcica confirmed a distinct enhancing lesion in the cavernous sinus and he was diagnosed with CSS as a result of bony metastasis from his prostate cancer. He was started on high-dose steroids, and underwent directed radiation therapy. Bone metastasis is common with prostate cancer with predilection for more proximal structures such as the iliac bones and lumbar spine. Cases of CSS stemming from metastatic prostate cancer are rare. Thus, the development of CN palsy and ophthalmoplegia along with orbital pain should trigger a thorough investigation of the etiology of CSS which should include primary malignancies and metastasis from more distant structures such as the prostate. KeywordsCavernous sinus syndrome, cranial nerve palsy, ophthalmoplegia, metastatic prostate cancer Disclosure: Brandon Kuiper, Aline Babikian, and Wilfred Delacruz have nothing to disclose in relation to this article. No funding was received for the publication of this article.Authorship: All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published.Compliance with Ethical Guidelines: All procedures were followed in accordance with the responsible committee on human experimentation and with the Helsinki Declaration of 1975 and subsequent revisions and informed consent was received from the patient involved in this case report.Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any noncommercial use, distribution, adaptation, and reproduction provided the original author(s) and source are given appropriate credit. Cavernous sinus syndrome (CSS) is a rare clinical entity characterized by headache, ophthalmoplegia, and neuropathy due to compression of vascular and nerve bundles that course through a narrow anatomical region in the skull.1,2 Myriad conditions lead to this syndrome including bacterial or fungal infection, thrombus, aneurysm, pituitary enlargement due to tumor or apoplexy, and primary or metastatic cancers.1-3 Prostate cancer has predisposition for bone metastasis, and bone is the predominant site of metastasis; however, skull involvement is less common. Metastatic prostate cancer in the...

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Metastasis to the base of the skulk clinical findings in 43 patients

Cited by 292 publications

References 0 publications

Collet Siccard Syndrome without skull base metastasis : A rare presentation of bronchogenic adenocarcinoma

Collet Siccard Syndrome without skull base metastasis : A rare presentation of bronchogenic adenocarcinoma

Cranial nerve deficit caused by skull metastasis of prostate cancer: three Japanese castration-resistant prostate cancer cases

Metastatic Prostate Cancer Manifesting as Cavernous Sinus Syndrome—Case Report and Review of the Literature

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