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Unusual skull base metastasis from neuroendocrine tumor: a case report

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Title: Unusual skull base metastasis from neuroendocrine tumor: a case report
Authors: Lim, KHJ
Valle, JW
Lamarca, A
Item Type: Journal Article
Abstract: BACKGROUND: With increasing treatment options available, neuroendocrine tumor has become a chronic disease and may present later on with atypical manifestation of disease spread once resistant to treatment. CASE PRESENTATION: A 74-year-old white British woman undergoing treatment for metastatic well-differentiated neuroendocrine tumor for the past 9 years presented with a brief history of mild frontal headache, and progressive left ptosis and ocular palsy. She had no visual loss, and had neither speech nor motor deficit. At the outset, it was crucial to exclude acute or missed stroke. An urgent magnetic resonance imaging of her head revealed an unusual skull base metastasis extending into the cavernous sinus, with no peritumoral edema. Following discussion at a specialist neuro-oncology meeting and a neuroendocrine tumor multidisciplinary team meeting, she proceeded to have conventional fractionated radiotherapy followed by subsequent palliative chemotherapy. CONCLUSIONS: Intracranial metastasis is rare in patients with neuroendocrine tumor, particularly in those with well-differentiated histology; skull base metastasis is even more uncommon. Management of intracranial metastasis from a rare tumor should always be discussed in a specialist multidisciplinary meeting. Surgery or radiotherapy, including stereotactic radiosurgery, should be considered in skull base metastases. Hormonal abnormalities may occur following radiotherapy to skull base metastases and should be monitored closely in the first few months post treatment.
Issue Date: 30-Aug-2019
Date of Acceptance: 31-Jul-2019
URI: http://hdl.handle.net/10044/1/73999
DOI: https://dx.doi.org/10.1186/s13256-019-2214-5
ISSN: 1752-1947
Publisher: BioMed Central
Journal / Book Title: Journal of Medical Case Reports
Volume: 13
Issue: 1
Copyright Statement: © The Author(s). 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, andreproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link tothe Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Cranial nerves
Endocrine tumor
Cranial nerves
Endocrine tumor
1199 Other Medical and Health Sciences
General & Internal Medicine
Publication Status: Published
Conference Place: England
Article Number: ARTN 273
Appears in Collections:Department of Immunology and Inflammation