title: Carcinomatous myelitis and meningitis after a squamous cell carcinoma of the lip.
abstract: BACKGROUND
  Nervous central system metastases from head and neck squamous cell carcinoma (SCC) are rare. We report an exceptional case of isolated leptomeningeal and spinal cord involvement few years after the diagnosis of invasive SCC of the lip.
  
  
  METHODS
  A 33-year-old man with a history of infracentimetric carcinoma of the lip developed back pain associated with progressive neurological disorders leading to paraplegia. This atypical presentation led to initial misdiagnosis, but radiological and cytological explorations finally confirmed the diagnosis of leptomeningeal and intramedullar secondary spinal cord lesions from his previously treated head and neck SCC. Systemic targeted therapy with epidermal growth factor receptor inhibitor and intrathecal chemotherapy led to prolonged disease stabilization.
  
  
  CONCLUSIONS
  To our knowledge, this is the first case of isolated neurological metastases from a head and neck SCC. Combination of systemic targeted therapy and intrathecal chemotherapy may be effective in such cases.
authors.affiliation: Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Pougnet
authors.affiliation: Department of Pathology, Institut Paoli-Calmettes, Marseille, France ; Department of Radiology, Institut Paoli-Calmettes, Marseille, France ; Department of Molecular Oncology, INSERM U1068, Centre de Recherche en Cancérologie de Marseille, Marseille, France ; University of Aix-Marseille, Marseille, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Murati
authors.affiliation: Department of Radiology, Institut Paoli-Calmettes, Marseille, France.
authors.forename: Anthony
authors.initials: A
authors.lastname: Sarran
authors.affiliation: Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France ; Department of Molecular Oncology, INSERM U1068, Centre de Recherche en Cancérologie de Marseille, Marseille, France ; CNRS UMR7258, CRCM, Marseille, France ; University of Aix-Marseille, Marseille, France.
authors.forename: Patrice
authors.initials: P
authors.lastname: Viens
authors.affiliation: Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France ; Department of Molecular Oncology, INSERM U1068, Centre de Recherche en Cancérologie de Marseille, Marseille, France ; CNRS UMR7258, CRCM, Marseille, France ; University of Aix-Marseille, Marseille, France.
authors.forename: Renaud
authors.initials: R
authors.lastname: Sabatier
keywords: Head and neck carcinoma; Meningitis; Spinal cord metastasis; Squamous cell