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Metastasis in the temporal bone mimicking temporal arteritis.

Päivi Jalava-Karvinen¹, Jukka Kemppainen, Riitta Saario

¹Department of Medicine, Turku University Hospital, Turku, Finland.

Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases

|January 7, 2010

Summary

A rare cancer metastasis to the temporal bone mimicked temporal arteritis in a patient with a history of breast cancer. This case highlights the importance of considering malignancy in atypical presentations of temporal arteritis.

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Area of Science:

Oncology
Neurology
Rheumatology

Background:

Temporal arteritis (TA) is an inflammation of arteries, typically the temporal arteries, causing symptoms like headache and visual disturbances.
Early diagnosis and treatment with corticosteroids are crucial to prevent vision loss and other complications of TA.

Observation:

A 72-year-old female with a history of breast cancer presented with symptoms mimicking TA: unilateral headache, visual disturbances, and elevated erythrocyte sedimentation rate.
Temporal artery biopsy was negative, and the patient did not respond to corticosteroid treatment, suggesting an alternative diagnosis.

Findings:

Whole body bone scintigraphy revealed widespread skeletal metastases, including in the temporal bone.
The temporal bone metastasis presented with symptoms and signs closely resembling temporal arteritis.

Implications:

This case underscores the potential for bone metastases to mimic inflammatory conditions like temporal arteritis.
Clinicians should maintain a high index of suspicion for malignancy in patients with suspected TA who do not respond to treatment or have atypical findings.