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Metastatic carcinoma mimicking a facial nerve schwannoma: the role of computerized tomography in diagnosis

Published online by Cambridge University Press:  08 March 2006

R Suryanarayanan
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Manchester Royal Infirmary, Manchester, UK
A Dezso
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Manchester Royal Infirmary, Manchester, UK
R T Ramsden
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Manchester Royal Infirmary, Manchester, UK
J E Gillespie
Affiliation:
Department of Radiology, Manchester Royal Infirmary, Manchester, UK

Abstract

Secondary deposits in the temporal bone are uncommon but well recognized. Such tumours may involve the facial nerve by direct extension of the destructive process into the fallopian canal. We present a rare case of metastasis from a breast carcinoma in the facial nerve itself, involving the nerve in the internal acoustic meatus with extension into the labyrinthine segment, the first genu and into the middle-ear segment. The rest of the temporal bone was not involved. The lesion resembled a facial schwannoma on a routine magnetic resonance (MR) image. The diagnosis was confirmed after a post-operative computed tomography (CT) scan showed another separate secondary deposit in the basisphenoid. Histology was consistent with secondary tumour from a breast carcinoma. The case highlights the importance of keeping a high degree of suspicion for metastatic tumours in patients with a previous history of malignancy and the usefulness of CT scan in the evaluation of such cases.

Type
Research Article
Copyright
© 2005 Royal Society of Medicine Press

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