Head and neck malignant metastasis to the cerebellopontine angle

Abstract

Objectives: To present 3 patients with isolated metastatic lesions to the cerebellopontine angle (CPA). The patient’s histories and clinical courses are reviewed. Methods: Clinical chart reviews of 3 patients with head and neck malignant lesions metastatic to the CPA was conducted. Results: The first patient had a temporal squamous skin cancer involving the temporal bone requiring a lateral temporal bone resection. The second and third patients had parotid adenocarcinomas with facial nerve involvement. Facial nerves were invaded by primary tumors in all 3 cases and peripheral facial paralyses were demonstrated. The CPA masses were found at 10–48 months after the primary tumor removal. One patient had developed hydrocephalus at presentation. Translabyrinthine resection of the CPA tumors was performed in all 3 cases. One patient is alive and free from disease 14 months postoperatively. One patient expired with pneumonia with disease at 21 months. The third patient died due to surgical complications on postoperative day 5. Conclusion: Malignant metastasis presenting as an isolated CPA tumor is rare. Only 1 squamous cell carcinoma and 2 adenocarcinoma from parotid malignancies metatastasizing to the CPA have been reported in the English literature. Our experience suggests that despite the poor prognosis of CNS metastasis of head and neck cancer, surgical management can provide a reasonable potential for cure and outcome in terms of palliative care.