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A Tale of Deviation
The Journal of the Association of Physicians of India
|August 12, 2015
Summary
A rare case of unilateral hypoglossal nerve palsy in a 52-year-old male was diagnosed as advanced prostate cancer with skull base metastasis. This presentation highlights a seldom-seen manifestation of prostatic malignancy.
Area of Science:
- Neurology
- Oncology
- Urology
Background:
- Unilateral isolated hypoglossal nerve palsy has diverse etiologies including neoplasia, trauma, infections, autoimmune, and vascular conditions.
- Prostatic malignancy, while common, rarely presents with neurological deficits as an initial symptom.
Observation:
- A 52-year-old male presented with unilateral right hypoglossal nerve palsy.
- Diagnostic evaluation revealed prostatic malignancy with metastasis to the skull base.
Findings:
- The patient's hypoglossal nerve palsy was the presenting sign of advanced prostate cancer.
- This case represents a rare instance of neurological manifestation preceding the diagnosis of prostate cancer.
Implications:
- Highlights the importance of considering metastatic malignancy in the differential diagnosis of isolated cranial nerve palsies.
- Suggests that hypoglossal nerve palsy can be an early, albeit uncommon, indicator of occult prostatic carcinoma.
- Emphasizes the need for thorough oncological workup in patients with unexplained neurological symptoms.
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