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Diagnostic Challenge: Sequential Unilateral Cranial Neuropathies Due to Perineural Spread of Carcinoma NEURO-OPHTHALMOLOGY Moss, H. E., MacIntosh, P. W., Slavin, K. V., Collins, J. M. 2017; 41 (4): 227–31

Abstract

An 86-year old man developed sequential dysfunction of trigeminal (V1), facial, abducens, trigeminal (v2), oculomotor, and hypoglossal cranial nerves on the right over 20 months. Magnetic resonance imaging (MRI) showed a lesion in the right cavernous sinus. Although there was clinical suspicion that this was related to perineural spread of an extracranial tumour, a primary lesion was not discovered. Stereotactic biopsies of the intracranial lesion were non-diagnostic, and the patient succumbed to his tumour following a period of rapid growth. Postmortem examination showed the intracranial lesion to be a carcinoma with squamous features. This case highlights the challenges of diagnosis of intracranial perineural spread and the potential for transformation from indolent to aggressive tumour behaviour.

View details for DOI 10.1080/01658107.2017.1304968

View details for Web of Science ID 000415700200012

View details for PubMedID 29344066

View details for PubMedCentralID PMC5762146