Lateral skull base metastasis from cervical adenocarcinoma: the masquerading trespasser - a case report

Metastatic lesions of the lateral skull base are rare and often diagnostically challenging, especially when originating from cervical adenocarcinoma - a malignancy not commonly associated with skull base involvement.

We report the case of a 52-year-old postmenopausal woman who presented with right-sided facial nerve palsy, tongue deviation, and multiple cranial nerve deficits. Clinical examination and imaging suggested a skull base mass involving the jugular foramen, petrous bone, and hypoglossal canal. Radiological evaluation revealed a soft tissue lesion with limited vascularity, and a provisional diagnosis of metastatic cervical adenocarcinoma was made. Surgical excision using a transmastoid transcervical (Fisch Type A) approach confirmed metastatic adenocarcinoma. A postoperative FDG-PET scan showed no residual or distant disease.

This case highlights an unusual metastatic route of cervical adenocarcinoma and emphasizes the need for thorough systemic evaluation in patients presenting with atypical cranial neuropathies.

Early diagnosis and targeted intervention can improve outcomes, even in rare metastatic scenarios.