Clear Cell Renal Cell Carcinoma with Meckel’s Cave Metastasis as Primary Presentation
Author : Sainadh K, Shejoy P Joshua, Shaheen AM and Dilip Panikar
Abstract :
Background: Renal cell carcinoma (RCC) accounts for 8% of all brain metastasis; however, spread to the cranial nerves and their ganglia is uncommon. To the best of our knowledge, we report the 3rd case of RCC metastatic to Meckel’s cave, which was diagnosed secondary to new trigeminal sensory symptoms.
Methods: An 80-year-old man had presented with history of right sided facial numbness since last 1 year. Patient had reduced sensation of hot and cold over the right half of his face. Magnetic resonance imaging demonstrated heterogeneous enhancing mixed solid-cystic lesion with haemorrhagic changes in the right CPA cistern extending into the right Meckel's cave.
Results: As the lesion is causing significant mass effect on the pons and right middle cerebellar peduncle with edema. Compression of the fourth ventricle causing mild obstructive hydrocephalus. Operative resection was recommended.
Conclusion: We have reported a case of RCC presenting with numbness via metastatic spread to Meckel’s cave. Although uncommon, metastasis is an important diagnostic consideration for enhancing cranial nerve lesions. Our case has demonstrated that, although a history of malignancy, multiple lesions, or systemic/constitutional symptoms are typical, rare cases can demonstrate isolated central nervous system findings.
Keywords :
Case Report, Cranial Nerve, Metastasis, Renal Cell Cancer, Skull Base, Trigeminal Nerve.
