Dual-isotope SPECT diagnosis of a skull-base metastasis causing isolated unilateral hypoglossal nerve palsy.
We describe a 48-year-old female with an isolated unilateral hypoglossal nerve palsy caused by a skull base metastasis from breast cancer. The patient had a medical history of conservative breast therapy for breast cancer. Although the cause of such a neurological deficit includes various pathologies, the reports focusing on metastatic tumor have been limited in number. Radiologic investigation showed a mass involving both the right hypoglossal canal and the clival edge. Swelling of the hypoglossal nerve was observed in views including its canal. Three-dimensional CT images demonstrated the tumor protruding from the enlarged external orifice of the hypoglossal canal. In the present report we mentioned a nuclear medicine procedure to visualize and characterize the small, abnormal tissue in the skull base. Dual-isotope SPECT confirmed an abnormal uptake of 99mTc-HMDP around the hypoglossal canal and a 201Tl-positive elongated lesion running along the hypoglossal nerve.
Fukumoto
M
M
Department of Radiology, Kochi Medical School, Japan.
Osaki
Y
Y
Yoshida
D
D
Ogawa
Y
Y
Fujiwara
M
M
Miyazaki
N
N
Kurohara
A
A
Akagi
N
N
Yoshida
S
S
D003389:Cranial Nerve Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D007002:Hypoglossal Nerve / Q000000981:diagnostic imaging*; D008875:Middle Aged; D019275:Radiopharmaceuticals; D012888:Skull Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000556:secondary*; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; C024226:technetium Tc 99m hydroxymethylene diphosphonate; D013669:Technetium Tc 99m Medronate