IMAGES IN NEUROLOGY
Trigeminal perineural spread of renal cell carcinoma
Propagação perineural trigeminal do carcinoma de células renais
Alejandro HornikI; Jordan RosenblumII; José BillerIII
IDepartment of Neurology, Chief Resident, Stritch School of Medicine, Loyola University Medical Center, Chicago, USA
IIDepartment of Radiology, Director Neuro-Radiology, Stritch School of Medicine, Loyola University Medical Center, Chicago, USA
IIIDepartment of Neurology, Chairman, Stritch School of Medicine, Loyola University Medical Center, Chicago, USA
Correspondence Correspondence: José Biller Department of Neurology, Loyola University Chicago, Stritch School of Medicine 2160 S. 1st Avenue / Bldg. 105, Room 2700 Maywood, IL 60153 E-mail: jbiller@lumc.edu
A 55-year-old man had a five-day history of "pins and needles" sensation on the left chin. Examination showed decreased pinprick sensation on the territory of the left mandibular branch of the trigeminal nerve. Brain magnetic resonance imaging (MRI) with gadolinium showed enhancement involving the left mandibular branch (Fig 1). Computed tomography (CT) of the chest, abdomen, and pelvis showed a left kidney mass (Fig 2) diagnosed as renal carcinoma following nephrectomy.
The "numb-chin" syndrome heralds or accompanies systemic malignancies1. Trigeminal perineural spread has been well-documented in head and neck neoplasms2, however, to our knowledge, it has not been reported in renal neoplasms.
Received 01 March 2012
Received in final form 30 April 2012
Accepted 07 May 2012
Conflict of interest: There is no conflict of interest to declare.
- 1. Lossos A, Siegal T. Numb chin syndrome in cancer patients: etiology, response to treatment, and prognostic significance. Neurology 1992;42:1181.
- 2. Warden KF, Parmar H, Trobe JD. Perineural spread of cancer along the three trigeminal divisions. J Neuro-Ophthalmology 2009;29: 300-307.
Correspondence:
Publication Dates
-
Publication in this collection
08 Oct 2012 -
Date of issue
Oct 2012