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Case Reports
. 2014 Jan 16;7(1):33-8.
doi: 10.1159/000358049. eCollection 2014 Jan.

Carcinomatous myelitis and meningitis after a squamous cell carcinoma of the lip

Isabelle Pougnet  1 , Anne Murati  2 , Anthony Sarran  3 , Patrice Viens  4 , Renaud Sabatier  4
Affiliations
Case Reports

Carcinomatous myelitis and meningitis after a squamous cell carcinoma of the lip

Isabelle Pougnet et al. Case Rep Oncol. .

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.

Case report: 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.

Conclusion: 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.

Keywords: Head and neck carcinoma; Meningitis; Spinal cord metastasis; Squamous cell.

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Figures

Fig. 1
Fig. 1
Facial T2 FLAIR-weighted MRI. Hyperintensity located in the left temporal fossa corresponding to a perineural invasion of the trigeminal nerve (arrow).
Fig. 2
Fig. 2
Spine MRI. a Sagittal plane: diffuse leptomeningeal pathological enhancement after gadolinium injection. b Axial plane: abnormal medullary signal enhancement and left paravertebral invasion (arrow).
Fig. 3
Fig. 3
CSF examination using Cytospin© with May-Grunwald Giemsa staining. a Many well-differentiated squamous cells are observed. b At higher enhancement (×50), few nuclear abnormalities were identified (arrow).
See this image and copyright information in PMC

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