Abstract
To determine if cerebrospinal fluid (CSF) cytology can be useful in the workup of patients with internal auditory canal/cerebellopontine angle (IAC/CPA) tumors and facial paralysis to diagnose metastatic disease before surgical intervention. Retrospective case series. Tertiary referral center. Patients who presented with or developed facial paralysis and IAC/CPA tumors. Lumbar puncture and CSF cytological analysis. Seven patients presented with or developed high-grade facial paralysis (greater than House-Brackmann Grade II). In the first patient, excision of the tumor revealed adenocarcinoma. All subsequent patients were evaluated with CSF cytological analysis. In five of these patients, cytological CSF analysis revealed malignant cells, suggesting a diagnosis of a metastatic lesion rather than acoustic neuroma. Primary neoplasms were identified in all but one of these patients. A sixth patient had metastatic breast cancer, but negative CSF cytology and a stable CPA tumor after radiation treatment. Two patients who were being conservatively followed up for their IAC/CPA tumor developed a nonprogressive but persistent mild Grade II facial weakness and underwent CSF analysis which tested negative. One patient had surgical resection with pathologic findings consistent with a typical acoustic schwannoma, and the other patient has been conservatively followed up without change. Our experience suggests that patients presenting with IAC/CPA tumors and progressive facial paralysis of House-Brackmann Grade III or greater should have a CSF cytological examination before surgical intervention to evaluate for a malignant process.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.