title: Metastatic breast carcinoma of the jugular foramen: a rare case of Villaret syndrome.
abstract: BACKGROUND
  The differential diagnosis of skull base masses is diverse and includes benign and malignant neoplasms, vascular anomalies, congenital lesions, as well as infectious and inflammatory processes. Metastatic masses of the skull base are a rare manifestation of systemic malignancies. Breast cancer is the most common cause of skull base metastases. Villaret syndrome refers to cranial nerves IX, X, XI, and XII and sympathetic chain neuropathies. It is a clinical subtype of jugular foramen syndromes.
  
  
  RESULTS
  A 62-year-old woman with a history of breast carcinoma presented with hoarseness dating to shortly after her mastectomy years earlier. CT angiography showed enhancing tissue just outside the right jugular foramen, and biopsy confirmed metastatic adenocarcinoma consistent with breast cancer.
  
  
  CONCLUSIONS
  Villaret syndrome caused by breast cancer metastases has not been previously described. We present a case of Villaret syndrome caused by metastasis of invasive breast adenocarcinoma and a review of the literature of metastases of breast cancer to the skull base.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Flis
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Ameer T
authors.initials: AT
authors.lastname: Shah
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Jeremiah C
authors.initials: JC
authors.lastname: Tracy
authors.affiliation: Department of Neurosurgery, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Carl B
authors.initials: CB
authors.lastname: Heilman
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Miriam A
authors.initials: MA
authors.lastname: O'Leary
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D003390:Cranial Nerve Neoplasms / Q000556:secondary* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006685:Hoarseness / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging / Q000379:methods; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D035583:Rare Diseases; D019292:Skull Base Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Villaret syndrome; breast carcinoma; jugular foramen; metastases; skull base