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CASE REPORT
When dizziness becomes sinister: oropharyngeal carcinoma presenting as a paraneoplastic neurological disorder
  1. Li Yong1,
  2. Panagiotis Asimakopoulos1,
  3. Colin Mumford2,
  4. Ioanna Fragkandrea Nixon3
  1. 1Department of ENT, St John's Hospital, Livingston, UK
  2. 2Department of Neurology, Western General Hospital, Edinburgh, UK
  3. 3Edinburgh Cancer Research Centre, Edinburgh Cancer Centre, Edinburgh, UK
  1. Correspondence to Dr Ioanna Fragkandrea Nixon, Ioanna.F.Nixon{at}gmail.com

Summary

Paraneoplastic neurological disorders are uncommon presentations of head and neck cancers. We present a case of a 68-year-old male patient who presented with dizziness, nausea and memory problems. MRI of his brain showed bilateral cerebellar leptomeningeal enhancing signal abnormality with cervical lymphadenopathy. CT imaging of his neck raised the suspicion of a tonsillar primary, which was later confirmed on biopsy. His poorly differentiated HPV positive squamous cell carcinoma was treated with chemoradiotherapy. Subsequent MRI imaging showed progressive cerebellar atrophy and his presenting symptoms persisted, but he remained disease free 6 months post-treatment for his primary malignancy.

https://doi.org/10.1136/bcr-2016-216151

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    Footnotes

    • Contributors All coauthors have equally contributed to this case report and consented in the final draft. CM is the treating neurologist, and IFN is the treating oncologist. LY and PA are trainees involved in the management of the patient discussed in the case report under the guidance and supervision of CM and IFN.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.