Carcinoma Prostate Presenting as Multiple Cranial Nerve Pals
Abstract
Metastatic prostatic carcinoma commonly involves bones and extra pelvic lymph nodes. CNS involvement is unusual and particularly the occurence of leptomeningeal metastasis is extremely rare, with few cases described in the literature.1 The reported incidence at autopsy vary from 0.6 to 4.4 percent.2 We report a 65 year old male who presented with multiple cranial nerve palsies due to leptomeningeal metastasis in carcinoma prostate treated with orchidectomy and planned for radiotherapy and antiandrogen therapy.

Introduction
Brain metastasis occurs in 25% of patients with malignancies and 50 percent of neoplasms in the brain are metastatic.3 The most common sources of metastasis to the brain are carcinoma lung, breast, kidney and melanoma.4,5 Brain metastasis following carcinoma prostate is rare. We present a 65 year old male who presented with multiple cranial nerve palsies due to leptomeningeal metastasis in carcinoma prostate.

Case Report
65 year old male, non smoker, presented to us with dysphagia with nasal regurgitation, and diplopia since 1 month. On examination, the patient was conscious, oriented, afebrile. He had cervical lymph node enlargement and left lateral rectus palsy. Pupil 3 mm equally reacting to light on both sides. Fundus examination was normal. Left gag reflex was sluggish (Figure 1). Tongue wasting and weakness was noted on both sides (Figure 2). Left 6th, left 10th and bilateral 12th cranial nerves were involved. Patient did not have any meningeal signs.....

http://www.japi.org/february_2017/20_cr_carcinoma_prostate_presenting_as.html
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