[Skull base metastasis of the breast cancer causing the Collet-Sicard syndrome--a case report (author's transl)]

Abstract

A 51-year-old female presented herself with complaints of mis-swallowing, hoarseness, speech disturbance and right stiff shoulder of 3 months duration. She had left breast cancer operated on elsewhere 10 years previously. Pertinent neurological findings were 9th, 10th, 11th and 12th cranial nerve palsies on the right (the Collet-Sicard syndrome). Cerebral angiography, retrograde jugular venography, polytomography of the skull base and bone scintigraphy with 99mTc-MDP raised a question of metastasis of the breast cancer to the skull base of the right mastoid region. Following right retromastoidal suboccipital craniectomy, partial removal of the metastatic skull tumor of the deep mastoid region was done. No intracranial extension of the tumor was confirmed. Multiple cranial nerve palsies above mentioned resolved following irradiation with betatron of 5000 rads. Pathology report was that of metastatic adenocarcinoma to the skull, which was similar to the histology of the breast cancer resected 10 years previously. Skull base metastasis of the breast cancer causing the Collet-Sicard symdrome is rare. To the author's knowledge, only 7 cases of the Collet-Sicard syndrome caused by metastatic tumors have been reported in the English and Japanese literatures. Primary lesions were as follows: The one was from the lung and the rest were all from the prostate. We are reporting the first case of the Collet-Sicard syndrome due to metastatic adenocarcinoma of the breast to the skull base.