Metastatic lung cancer presenting with jugular foramen syndrome in a case of von Recklinghausens disease

Abstract

Metastatic carcinomas from a distant primary malignancy involving the temporal bone particularly the jugular foramen are rare tumors. A 57-year-old gentleman had multiple gradually increasing swellings over the body since many years. For last two years, he noticed enlargement of the swelling in left calf and rapidly enlarging painful new swelling over the left chest wall in back for last one year. He had recent involvement of left seventh, eighth and lower cranial nerves. CT scan showed an extensive lesion in left jugular foramen region with bone destruction. The patient underwent decompression of the left jugular foramen mass lesion. The tumor was extremely vascular and a partial decompression could only be performed. Although there was relief in the headache but the neurological deficits were persisting. Histopathology of the tumor showed features of metastatic small ling cancer. In the present case, there was presence of long standing multiple swelling all over the body and the patient had painful enlargement that he perceived as an ongoing process of the von Recklinghausen's disease and made a delay in seeking the medical advice resulting in a well advanced disease and with poor prognosis.

Glossopharyngeal and Hypoglossal Nerve Paralysis Secondary to Prevertebral Phlegmon

“…Jugular foramen syndrome does not generally involve damage to the hypoglossal nerve [7][8][9][10][11]; however, pressure exerted on the carotid space may lead to hypoglossal nerve dysfunction. In the present case, the patient had hypoglossal nerve paralysis, which made us believe that the pathogenesis was due to pressure on the carotid space.…”

Jugular Foramen Syndrome as Initial Presentation of Metastatic Lung Cancer

“…15 Jugular foramen syndrome, or Vernet's syndrome, is characterized by dysfunction of the IX, X, and XI cranial nerves. 3,8,[15][16][17] Impingement of the vagus nerve at the level of the jugular foramen causes paralysis of the laryngeal muscles resulting in hoarseness and a nasal pitch. 8,[15][16][17] Further vagal compression results in unilateral paralysis of the soft palate and uvular deviation to the effected side.…”

“…3,8,[15][16][17] Impingement of the vagus nerve at the level of the jugular foramen causes paralysis of the laryngeal muscles resulting in hoarseness and a nasal pitch. 8,[15][16][17] Further vagal compression results in unilateral paralysis of the soft palate and uvular deviation to the effected side. Involvement of the glossopharyngeal nerve results in a loss of sensation to the ipsilateral posterior tongue, decreased secretions from the ipsilateral parotid gland, and loss of the ipsilateral gag reflex.…”

The collet-sicard syndrome and dentistry: case report

“…The initial aspect is shown in Figures 2 and 3. The etiology of these pathologies may arise from benign or malignant tumors [7,8] metastases [9], and infections [10], or be considered idiopathic [11].…”