Abstract
Isolated facial nerve paralysis is rarely the result of metastasis. We report a case of facial nerve palsy secondary to metastatic lung cancer to the temporal bone. A 62-year-old woman presented with acute-onset facial nerve weakness with facial pain on the right side. She also complained of right temporal pain and left shoulder pain. At the time of presentation with facial weakness, hearing and lacrimation were grossly intact. Taste was slightly impaired. She had low-grade fever and laboratory findings demonstrated leukocytosis (12, 500/μl) and elevated CRP (13.7mg/dl). Chest X-ray demonstrated lung tumor. After further examination, the patient was diagnosed as having squamous cell carcinoma of the lung with bone metastasis to the temporal bone. Isolated facial nerve palsy as a consequence of metastatic disease involving the temporal bone is rare. Although progressive, unilateral, peripheral facial nerve paresis over weeks is strongly suggestive of neoplasm, the sudden onset of peripheral nerve paralysis, as in our patient, does not exclude the diagnosis of tumor. It is therefore, imperative to consider the possibility of a malignant neoplasm in patients with atypical symptoms.
