Prostate cancer metastasis to clivus causing cranial nerve VI palsy

Malloy, Kelly A.

doi:10.1016/j.optm.2006.08.015

Cited by 26 publications

(16 citation statements)

References 17 publications

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“…Rao [14] and Saito et al [15] The present case was similar to the patient described by Malloy [11], with prostate cancer metastasis to the clivus and presentation with abduction deficits and 6 th cranial nerve involvement.…”

Section: Discussionsupporting

confidence: 82%

“…Headache and cognitive changes are the most frequent symptoms of increasing intracranial pressure. Cranial nerve palsies caused by metastases from the prostate to the clivus are uncommon [11]. Other described neurological findings are motor deficits, mental status changes, gait disturbance, vertigo, multiple cranial nerve palsies, and inappropriate secretion of antidiuretic hormone syndrome [8].…”

Section: Discussionmentioning

confidence: 99%

“…Other described neurological findings are motor deficits, mental status changes, gait disturbance, vertigo, multiple cranial nerve palsies, and inappropriate secretion of antidiuretic hormone syndrome [8]. Clivus metastasis from prostate cancer presenting with nerve compression is a very rare entity, but it has been described previously [11]. Table 1 contains a summary of published reports of patients with intracranial prostate metastasis.…”

Section: Discussionmentioning

confidence: 99%

“…The patient described by Malloy [11] was treated with intracranial radiotherapy for visual symptoms. In our case, the CT scan of the skull showed destruction of the clivus and involvement of the Dorello canal, with multiple metastatic calvarium lesions without pituitary or cavernous sinus involvement.…”

Section: Discussionmentioning

confidence: 99%

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Prostate Cancer Presenting With Neurologic Deficits and Visual Symptoms: Uncommon Presentation of a Common Malignancy

Bhargava

Aoun

Herawi³

et al. 2010

UIJ

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Intracranial metastases from prostate adenocarcinoma are very unusual, and initial presentation with symptomatic brain involvement is especially rare. We describe a 65-year-old male who presented with blurred vision and was found to have abducent nerve involvement and high-grade metastatic prostate cancer. Computed tomography of his head revealed a destructive lesion involving the clivus. He was started on hormonal treatment and his visual symptoms improved. Repeat scans after 6 months revealed resolution of the clivus lesion. Prostate cancer can occasionally present with neurologic manifestations, predominantly due to metastatic involvement of the skull bone. Awareness of this possibility could lead to accurate diagnosis. Initiation of appropriate therapy can successfully reverse the neurologic deficits.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prostate Cancer Presenting With Neurologic Deficits and Visual Symptoms: Uncommon Presentation of a Common Malignancy

Bhargava

Aoun

Herawi³

et al. 2010

UIJ

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“…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%

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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Cranial nerve palsy caused by metastasis to the skull base in patients with castration‐resistant prostate cancer: Three case reports

et al. 2021

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Introduction Skull base metastasis of prostate cancer associated with cranial nerve palsy is rare. We observed three patients with aggressive prostate cancer who experienced cranial nerve palsy. Case presentation Case 1 was a 53‐year‐old patient who was treated with carboplatin and etoposide. He noticed sensory abnormalities on his left mouth edge. Head magnetic resonance imaging revealed skull base metastasis. Case 2 was a 50‐year‐old patient who received docetaxel. This patient exhibited ptosis of the left eye. Skull base metastasis was detected by magnetic resonance imaging. External beam radiation therapy was performed. Case 3 was a 64‐year‐old patient who was treated with docetaxel. He experienced ptosis of the right eye and diplopia. He was also treated with external beam radiation therapy. Conclusion External beam radiation therapy exhibited some efficacy against the symptoms, but skull base metastasis of treatment‐resistant prostate cancer has poor prognosis. Three patients died within 3 months after symptoms occurred with or without external beam radiation therapy.

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Prostate cancer metastasis to clivus causing cranial nerve VI palsy

Cited by 26 publications

References 17 publications

Prostate Cancer Presenting With Neurologic Deficits and Visual Symptoms: Uncommon Presentation of a Common Malignancy

Prostate Cancer Presenting With Neurologic Deficits and Visual Symptoms: Uncommon Presentation of a Common Malignancy

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

Cranial nerve palsy caused by metastasis to the skull base in patients with castration‐resistant prostate cancer: Three case reports

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