Metastase eines Trachealkarzinoms im Bereich der Felsenbeinspitze

Background

Tumours and metastases of the lateral skull base are rare findings. Clinically, the progressive involvement of ipsilateral cranial nerves is important.

Case report

A 69-year-old man presented with headache and palsies of the facial nerve and nerve VI. Furthermore, he had hearing loss and hypaesthesia of the trigeminal nerve (V3). Four months previously, laser therapy for carcinoma of the trachea (cT4 cN3 cM0) had been done. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed an intrapetrosal mass with destruction of the lateral skull base. The findings suggested a metastasis of the tracheal carcinoma. We performed a mastoidectomy with specimen collection, and the pathological analysis revealed infiltration of a squamous cell carcinoma. The patient died within 3 weeks after radiotherapy with palliative intention despite malignant progression.

Conclusion

The diagnosis and therapy of metastases to the lateral skull base is an interdisciplinary challenge. CT and MRI scans are essential for planning further procedures. In cases of headache and cranial nerve palsies, a metastasis to the lateral skull base must be considered in the differential diagnosis.