Metastatic breast cancer presenting as sequential cranial nerve palsy: a case reportReport as inadecuate

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Journal of Medical Case Reports

, 8:430

First Online: 16 December 2014Received: 18 May 2014Accepted: 06 October 2014DOI: 10.1186-1752-1947-8-430

Cite this article as: Madgula, I.M., Hemmerdinger, C.M. & Clark, P. J Med Case Reports 2014 8: 430. doi:10.1186-1752-1947-8-430


IntroductionCranial nerve palsy is a common presentation in the neuro-ophthalmology clinic and investigations are directed towards the cause. Metastatic breast cancer presenting as carcinomatous meningitis leading to sequential fourth, third and sixth nerve palsy is very rare. This is the first case to be reported to the best of our knowledge.

Case presentationA 66-year-old Caucasian woman presented with vertical double vision for the previous 3 weeks. At 6-weeks follow up this had resolved. However, she presented with a new third and sixth cranial nerve palsy. Neuroimaging with contrast revealed carcinomatous meningitis.

ConclusionsMetastatic cancer may manifest as cerebral metastases or carcinomatous meningitis. This is evident on neuroimaging with contrast and may be missed on unenhanced scans.

KeywordsBreast cancer Carcinomatous meningitis Cranial nerve palsy Metastases Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-8-430 contains supplementary material, which is available to authorized users.

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Author: Indira M Madgula - Christopher M Hemmerdinger - Peter Clark


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