Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Metastatic Adenocarcinoma of Temporal Bone with Collet-Sicard Syndrome

Document Type : Case Report

Authors
Sethu Subha
Abdul-Jalil Nordin
Department of Otorhinolaryngology, University Putra Malaysia (UPM), Selangor, Malaysia.
10.22038/ijorl.2017.24308.1796
Abstract
Introduction:
Metastatic tumors of the temporal bone are extremely rare. Collet-Sicard syndrome is an uncommon condition characterized by unilateral palsy of the lower four cranial nerves. The clinical features of temporal bone metastasis are nonspecific and mimic infections such as chronic otitis media and mastoiditis.
 
Case Report:
This report describes a rare case of metastatic adenocarcinoma of the temporal bone causing Collet-Sicard syndrome, presenting with hearing loss, headache and ipsilateral cranial nerve palsies. The patient was a 68-year old woman initially diagnosed with extensive mastoiditis and later confirmed as having metastatic adenocarcinoma of the temporal bone, based on histopathologic findings.
 
Conclusion:
Clinical presentation of metastatic carcinoma of the temporal bone can be overshadowed by infective or inflammatory conditions. This case report is to emphasize the point that a high index of clinical suspicion is necessary for the early diagnosis of this aggressive disease which carries relatively poor prognosis. This report highlights that it is crucial to suspect malignant neoplasm in patients with hearing loss, headache and cranial nerve palsies.
Keywords
Adenocarcinoma
Collet-Sicard syndrome
Cranial nerve palsies
Computed Tomography
18F-FDG PET-CT (18 Fluorodeoxyglucose Positron Emission Tomography Computerised Tomography)
Metastasis
Temporal bone
Subjects
1. Streitmann M, Sismanis A. Metastatic carcinoma of the temporal bone. Am J Otol 1996;17:780–3.
2. Lan MY, Shiao AS, Li WY. Facial paralysis caused by metastasis of breast carcinoma to the temporal bone. J Chin Med Assoc 2004;67:587–90.
3. Kedjanyi WK, Bath AP, Ball RY, Hosni AA, Wickstead M.  Metastatic adenocarcinoma of the temporal bone. J Laryngol Otol 1994;108:710–12.
4. Villatoro R, Romero C  Rueda A. Collet-Sicard syndrome as an initial presentation of prostate cancer: a case report. J Med Case Rep2011;5:1–3.
5. Hayward D, Morgan C , Emami B, Biller J, Prabhu VC. Jugular foramen syndrome as initial presentation of metastatic lung cancer. J Neurol Surg Rep 2012;73:14–18.
6. Hosokawa S, Mizuta K, Iwasaki S, Araki S, Takebayashi S, Mineta H. A rare case of metastasis to the temporal bone from prostate adenocarcinoma. Int J Head Neck Surg 2006;1(2).
7. Hill BA, Kohut RI. Metastatic adenocarcinoma of the temporal bone. Arch Otolaryngol 1976;102:
568–71.
8. Suryanarayanan R, Dezso A, Ramsden RT, Gillespie JE. Metastatic carcinoma mimicking a facial nerve schwannoma: the role of computerized tomography in diagnosis J Laryngol Otol 2005; 119:1010–12.
9. Wynn A, John CJ, David JP, Kathryn C, David ES. Primary Adenocarcinoma of the Middle Ear. AJNR 1982;3:674–6.
10. Tsakiropoulou E, Fyrmpas G, Konstantinidis I, Efstratiou I, Constantinidis I. Temporal bone metastasis from breast carcinoma. Otorhinolaryngol Head Neck Surg 2013;52:30–2.
11. Erynne AF, Hal R, Rihan K, Abraham J. Metastatic prostate cancer to the left temporal bone: a case report and review of the literature. Case reports in Otolaryngology Hindawi Publishing Corporation. 2015;article ID 250312, 8 pages.
12. Tot T. Cytokeratins 20 and 7 as biomarkers: usefulness in discriminating primary from metastatic adenocarcinoma. Eur J Cancer. 2002; 38:758–63.
13. Belal A Jr. Metastatic tumors of the temporal bone A histopathological report. J Laryngol Otol 1985;99:839–46.
Iranian Journal of Otorhinolaryngology
Volume 30, Issue 6 - Serial Number 101
November and December 2018
Pages 361-364