Skull Base Metastasis Revealed by Bone Scintigraphy in a Patient With Hypoglossal Nerve Palsy

The Neurohospitalist
Aristeidis H KatsanosVasileios Ragos

Abstract

Even though different imaging modalities are available in sole or in combination for the optimal detection of bone metastases, whole-body bone scintigraphy (BS) in a single session seems to be advantageous. We present an 80-year-old male with unilateral left hypoglossal nerve palsy (HNP) and no other focal deficits on neurological examination. Initial brain computed tomography (CT) scan revealed no pathological findings, while the subsequent cranial CT and magnetic resonance imaging (MRI) scans uncovered only mild nonspecific sclerotic lesions in left occipital condyle. All laboratory examinations were within normal limits, except for an elevated alkaline phosphatase (170 U/L) and a markedly increased prostate-specific antigen (609 ng/mL). The patient underwent whole-body BS with technetium-99m that revealed increased radiotracer deposition compatible with metastases in multiple foci, including the left occipital condyle. Prostate biopsy confirmed the diagnosis of prostate adenocarcinoma. Our case suggests that a complete and thorough workup for hidden malignancies should be performed in all patients with HNP, even in the absence of a finding in brain neuroimaging. Bone scintigraphy is an essential investigation that should be ...Continue Reading

References

Sep 1, 1994·Radiographics : a Review Publication of the Radiological Society of North America, Inc·E O Thompson, W R Smoker
Jun 24, 1998·Clinical Neurology and Neurosurgery·S DemischS Zierz
Dec 29, 2000·The Journal of Trauma·T M SuS C Tsai
Feb 14, 2007·The Journal of Laryngology and Otology·S G KhooJ E Fenton
Jul 12, 2007·European Neurology·Marina BobanMarko Rados
Sep 26, 2015·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Ryogo MinamimotoAndrei H Iagaru
Nov 2, 2016·Muscle & Nerve·Amro M StinoSrivan Nagi Reddy

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Citations

Sep 23, 2021·The Neuroradiology Journal·Riccardo RussoMauro Bergui

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