[Peripheral facial palsy as the first symptom of a metastatic bronchogenic carcinoma].
BACKGROUND
We present a case of a facial palsy as the initial symptom of a bronchogenic carcinoma.


METHODS
Case-report. A 56-year-old patient presented with a peripheral facial palsy. The clinical picture as well as the temporal bone CT were without pathological findings. A 10-day rheologic therapy as well as anti-viral medication were not successful. Five days after rheological therapy had been completed, the patient presented a swelling of the neck. In the computer tomography we found a bilateral thrombosis of the internal jugular vein. In addition, the clinical picture of a left-sided glossopharyngeal palsy appeared. The following thorax CT as well as the diagnostic extirpation of an enlarged cervical lymph node lead to the diagnosis of a metastasized smallcell neuro-endocrine bronchogenic carcinoma with a compression of the right primary bronchus and the vena cava superior as well as an upper inflow congestion. In the cMRT we furthermore found a metastasis in the area of the foramen stylomastoideum. The patient underwent emergency radiation and chemotherapy.


RESULTS
According to the present findings, this metastasis lead to the facial palsy as the initial symptom of the bronchogenic carcinoma.


CONCLUSIONS
Therefore, therapy resistant facial palsy should be further diagnosed in detail, especially examined by imaging procedures.
Teschner
M
M
Hals-Nasen-Ohrenklinik der Medizinischen Hochschule Hannover. teschner.magnus@mh-hannover.de
Durisin
M
M
Mangold
A
A
Lenarz
T
T
Stöver
T
T
D001932:Brain Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D002283:Carcinoma, Bronchogenic / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary; D002528:Cerebellar Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary / Q000628:therapy; D003131:Combined Modality Therapy; D005158:Facial Paralysis / Q000209:etiology*; D020435:Glossopharyngeal Nerve Diseases / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007601:Jugular Veins; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000401:mortality; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000175:diagnosis / Q000209:etiology; D011379:Prognosis; D013902:Radiography, Thoracic; D012888:Skull Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary*; D013701:Temporal Bone; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D020246:Venous Thrombosis / Q000000981:diagnostic imaging