A 59-year-old man was diagnosed with squamous cell carcinoma of the larynx T2N2b. He was initially treated with three cycles of chemotherapy without radical remission. Three months later, a modified left laryngectomy was performed.
Pathological examination revealed a squamous cell carcinoma arising in the left hemiepiglotis with 8 out of 11 positive lymph nodes in the internal jugular chain, subdigestive lymph nodes and left supraclavicular lymph nodes.
Later he received chemotherapy and radiotherapy on supraglotis and hypopharynx and bilateral ganglion areas.
Nine months after surgery, the patient consulted due to headache of three weeks duration associated with binocular diplopia and blurred vision, mental illness and mental illness in the third, fourth and sixth cranial nerves.
Magnetic resonance imaging (MRI) showed a mass in the posterior and lateral sensing sinus of the right lax with protrusion of the prepontine cistern, well delimited, with homogeneous uptake of gadolinium 11 lesions.
TAC was negative.
Radiological differential diagnosis included meningitis or metastases.
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An open biopsy was performed with a transilvian approach to the lateral wall of the malignant sinus where the intradural space invasion was observed.
The pathological result was squamous cell carcinoma.
Subsequently, palliative radiotherapy was administered.
Three weeks after surgery the patient complained of back pain without neurological symptoms.
A MRI scan showed focal lesions in the D6 and D10 soft tissues bodies of metastatic implants.
Headache was diagnosed with radiotherapy, but the patient developed persistent headache that only preserved the right eye.
The patient died nine months after the diagnosis of metastasis to the malignant sinus.
