Laryngo- rhino- otologie · 2006
[Peripheral facial palsy as the first symptom of a metastatic bronchogenic carcinoma].
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Teschner M, Durisin M, Mangold A, Lenarz T, Stöver T
Аннотация
BACKGROUND: We present a case of a facial palsy as the initial symptom of a bronchogenic carcinoma.
METHODS: Case-report. A 56-year-old patient presented with a peripheral facial palsy. The clinical picture as well as the temporal bone CT were without pathological findings. A 10-day rheologic therapy as well as anti-viral medication were not successful. Five days after rheological therapy had been completed, the patient presented a swelling of the neck. In the computer tomography we found a bilateral thrombosis of the internal jugular vein. In addition, the clinical picture of a left-sided glossopharyngeal palsy appeared. The following thorax CT as well as the diagnostic extirpation of an enlarged cervical lymph node lead to the diagnosis of a metastasized smallcell neuro-endocrine bronchogenic carcinoma with a compression of the right primary bronchus and the vena cava superior as well as an upper inflow congestion. In the cMRT we furthermore found a metastasis in the area of the foramen stylomastoideum. The patient underwent emergency radiation and chemotherapy.
RESULTS: According to the present findings, this metastasis lead to the facial palsy as the initial symptom of the bronchogenic carcinoma.
CONCLUSION: Therefore, therapy resistant facial palsy should be further diagnosed in detail, especially examined by imaging procedures.
METHODS: Case-report. A 56-year-old patient presented with a peripheral facial palsy. The clinical picture as well as the temporal bone CT were without pathological findings. A 10-day rheologic therapy as well as anti-viral medication were not successful. Five days after rheological therapy had been completed, the patient presented a swelling of the neck. In the computer tomography we found a bilateral thrombosis of the internal jugular vein. In addition, the clinical picture of a left-sided glossopharyngeal palsy appeared. The following thorax CT as well as the diagnostic extirpation of an enlarged cervical lymph node lead to the diagnosis of a metastasized smallcell neuro-endocrine bronchogenic carcinoma with a compression of the right primary bronchus and the vena cava superior as well as an upper inflow congestion. In the cMRT we furthermore found a metastasis in the area of the foramen stylomastoideum. The patient underwent emergency radiation and chemotherapy.
RESULTS: According to the present findings, this metastasis lead to the facial palsy as the initial symptom of the bronchogenic carcinoma.
CONCLUSION: Therefore, therapy resistant facial palsy should be further diagnosed in detail, especially examined by imaging procedures.
Предметные рубрики MeSH
Brain NeoplasmsCarcinoma, BronchogenicCerebellar NeoplasmsCombined Modality TherapyFacial ParalysisGlossopharyngeal Nerve DiseasesHumansJugular VeinsLung NeoplasmsMagnetic Resonance ImagingMaleMiddle AgedParalysisPrognosisRadiography, ThoracicSkull NeoplasmsTemporal BoneTime FactorsTomography, X-Ray ComputedVenous Thrombosis