title: [Ophthalmoplegia in a patient with prostate cancer and bone metastases].
abstract: Prognosis in prostate cancer is determined, in greater part, by the presence of metastases. Bone metastases can occur in any part of the skeleton even, for example, at the base of the skull. We present a case of a 78 year old male who, in December 2001, presented with paralysis of the third cranial nerve. The NMR and CAT scans were normal and circulating levels of PSA were elevated. He was referred to the Urology Service where the treatment guidelines included complete androgen block. Subsequently, he developed retro-orbital pain, divergent strabismus and palpebral ptosis. CAT and NMR indicated a soft tissue mass at the sphenoid level. Treatment was Gamma Knife Radio-surgery. Since August 2004, in conjunction with the latest rise in PSA, the patients general status deteriorated considerably and he was referred to the Oncology Service. There was an increase in the paralysis of the third, fourth and sixth cranial nerve (complete left ophthalmoplegia) and left-central facial paralysis. Metastases from prostate cancer can be disseminated via the lymphatic or the blood system. Currently, there are more metastases from large-size tumours. Metastases are critical in prostate cancer because of their adverse effect on the patients survival. Measurements of circulating levels of prostate specific antigen and prostate acid phosphatase are very useful in the clinical diagnosis of the primary tumour, or its metastases.
authors.affiliation: Servicio De Oncología Médica, Hospital General Universitario de Elche, Camí de l'Almazara 11, 03203 Elche, Alicante, Spain. smacia@tiscali.es
authors.forename: Sonia
authors.initials: S
authors.lastname: Maciá Escalante
authors.forename: Carmen
authors.initials: C
authors.lastname: Guillén Ponce
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Molina Garrido
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Martínez Ortiz
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Ballester Navarro
authors.forename: Alfredo
authors.initials: A
authors.lastname: Carrato Mena
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary*; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary*; D006801:Humans; D008297:Male; D015840:Oculomotor Nerve Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D009886:Ophthalmoplegia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000473:pathology*
chemical_list: D018931:Antineoplastic Agents, Hormonal