title: When dizziness becomes sinister: oropharyngeal carcinoma presenting as a paraneoplastic neurological disorder.
abstract: Paraneoplastic neurological disorders are uncommon presentations of head and neck cancers. We present a case of a 68-year-old male patient who presented with dizziness, nausea and memory problems. MRI of his brain showed bilateral cerebellar leptomeningeal enhancing signal abnormality with cervical lymphadenopathy. CT imaging of his neck raised the suspicion of a tonsillar primary, which was later confirmed on biopsy. His poorly differentiated HPV positive squamous cell carcinoma was treated with chemoradiotherapy. Subsequent MRI imaging showed progressive cerebellar atrophy and his presenting symptoms persisted, but he remained disease free 6 months post-treatment for his primary malignancy.
authors.affiliation: Department of ENT, St John's Hospital, Livingston, UK.
authors.forename: Li
authors.initials: L
authors.lastname: Yong
authors.affiliation: Department of ENT, St John's Hospital, Livingston, UK.
authors.forename: Panagiotis
authors.identifier: http://orcid.org/0000-0003-3366-7883
authors.initials: P
authors.lastname: Asimakopoulos
authors.affiliation: Department of Neurology, Western General Hospital, Edinburgh, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Mumford
authors.affiliation: Edinburgh Cancer Research Centre, Edinburgh Cancer Centre, Edinburgh, UK.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Fragkandrea Nixon
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy / Q000821:virology; D002526:Cerebellar Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000627:therapeutic use; D004244:Dizziness / Q000209:etiology*; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy / Q000821:virology; D006801:Humans; D000072281:Lymphadenopathy; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D009325:Nausea / Q000209:etiology; D009333:Neck; D009959:Oropharyngeal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy / Q000821:virology; D030361:Papillomavirus Infections / Q000150:complications*; D020361:Paraneoplastic Syndromes, Nervous System / Q000000981:diagnostic imaging / Q000209:etiology*; D011878:Radiotherapy; D000077195:Squamous Cell Carcinoma of Head and Neck; D014057:Tomography, X-Ray Computed; D014067:Tonsillar Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy / Q000821:virology
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin