RESUMO
Facial nerve palsy due to temporal bone metastasis of hepatocellular carcinoma (HCC) has rarely been reported. We experienced a rare case of temporal bone metastasis of HCC that initially presented as facial nerve palsy and was diagnosed by surgical biopsy. This patient also discovered for the first time that he had chronic hepatitis B and C infections due to this facial nerve palsy. Radiation therapy greatly relieved the facial pain and facial nerve palsy. This report suggests that hepatologists should consider metastatic HCC as a rare but possible cause of new-onset cranial neuropathy in patients with chronic viral hepatitis.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Hepatocelular/complicações , Doenças do Nervo Facial/diagnóstico , Dor Facial/etiologia , Paralisia Facial/diagnóstico , Hepatite B Crônica/diagnóstico , Hepatite C Crônica/diagnóstico , Imuno-Histoquímica , Neoplasias Hepáticas/complicações , Imageamento por Ressonância Magnética , Tomografia por Emissão de Pósitrons , Neoplasias Cranianas/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
A 71-year-old diabetic male who had undergone coronary artery bypass surgery 8-years ago due to coronary artery disease, complained of hiccups for 3 days and worsening of anginal symptoms, which was proven to be with Staphylococcus hominis bacteremia. The patient was finally diagnosed with a mycotic aneurysm of the ascending aorta. All of the branches originating from the ascending aorta were narrowed due to the aortitis, including the origin of the left subclavian artery, which was supplying the left anterior descending artery as a result of bypass surgery. This might have been the cause of the chest pain and hiccups, since the vagus nerve is near the left subclavian artery. Three-dimensional chest computed tomography examination revealed a massive extension of the aortitis.