Brain Metastases Secondary to Advanced Laryngeal Cancer Presenting as Diminution of Vision and Lower Limb Weakness

Abstract

ABSTRACTObjectiveIntracranial metastases from primary laryngeal carcinoma are extremely rare and to present as diminution of vision has not been reported in published English literature. We present a case of advanced laryngeal carcinoma, who after treatment with surgery and chemo radiation, presented with decreased vision and weakness of lower limbs secondary to brain metastases.Case reportA 35-year-old male presented with dysphonia and L upper neck swelling. Endoscopy revealed a left supraglottic mass with fixed vocal cord and pathology of primary site and neck swelling reported it as moderately differentiated squamous cell carcinoma. Clinical and radiological assessment staged the tumor as T3N2bM0. Patient underwent combined standard surgical and medical treatment. Eight months after completion of treatment patient presented as decreased visual acuity (R > L) and gradually progressing weakness of lower limbs. Evidence of papilloedema on fundus exam prompted an urgent CT brain which showed multiple metastatic deposits in brain. There was no evidence of metastases in lungs, bones or liver.ConclusionBrain metastases are a known entity in Head and Neck cancer. Larynx as a primary site for the same should be kept in consideration with an atypical presentation as in present case.