DOI: 10.12890/2025_005329
Peripheral facial palsy in small cell lung cancer with mastoid metastasis. Peripheral facial palsy in small cell lung cancer with mastoid metastasis
Authors
marianasofiagaspar95@gmail.com
Keywords
Small cell lung cancer, mastoid metastasis, facial nerve palsy, venous sinus thrombosisAbstract
Introduction: Peripheral facial palsy is commonly associated with benign self-limited conditions. In rare circumstances, it may be the manifestation of underlying malignancy.
Case description: We present an unusual case of a 53-year-old woman with previously diagnosed small cell lung cancer (SCLC), who developed sudden-onset peripheral facial palsy. Imaging studies revealed mastoid metastasis with facial nerve involvement and venous sinus thrombosis, despite a normal MRI performed just one month prior. Despite ongoing treatment, the disease showed rapid progression culminating in the patient’s death.
Discussion: Metastatic involvement of the mastoid is extremely rare in SCLC. Such metastases can occur via haematogenous or meningeal spread, resulting in complex clinical phenotypes with mastoid involvement, including facial palsy and venous sinus thrombosis among others.
Conclusion: This case emphasises the importance of individualised assessment in peripheral facial palsy and vigilance regarding unusual metastatic patterns in cancer patients. The rapid clinical deterioration despite appropriate treatment underscores both the aggressive nature of SCLC and the critical need for more effective treatment strategies.
References
- Kim SJ, Lee HY. Acute peripheral facial palsy: recent guidelines and a systematic review of the literature. J Korean Med Sci 2020;35:e245.
- Ganti AKP, Loo BW, Bassetti M, Blakely C, Chiang A, D’Amico TA, et al. Small Cell Lung Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2021;19:1441–1464.
- Keane JR: Multiple cranial nerve palsies: analysis of 979 cases. Arch Neurol 2005;62:1714–1717.
- Gloria-Cruz TI, Schachern PA, Paparella MM, Adams GL, Fulton SE. Metastases to temporal bones from primary nonsystemic malignant neoplasms. Arch Otolaryngol Head Neck Surg 2000;126:209–214.
- Hartmann GG, Sage J: Small cell lung cancer neuronal features and their implications for tumor progression, metastasis, and therapy. Mol Cancer Res 2024;22:787–795.
