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다발성 뇌신경마비를 보인 간세포 암의 두개저 전이

Metastatic Hepatocelluar Carcinoma to the Skull Base with Manifestation of Multiple Cranial Nerves Palsies

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We experienced the patient of HCC metastasizing to the skull base involving multiple cranial nerves. A 67-year-old man presented with symptoms of diplopia, hoarseness and dysphagia which had been developed two weeks ago. On neurologic examination, he showed the disturbances of the right abducens nerve and the low cranial nerves from ninth to twelfth. Neuroimaging studies revealed the destructive mass in skull base, including clivus, petrosal bone and occipital condyle on the right side, with involvement of hypopharyngeal canal and cavernous sinus. The diagnosis of metastatic HCC to the skull base was made on the basis of neurological finding and imaging studies without histological examination. Although metastatic HCC to the skull base involving multiple cranial nerves is very rare, we need to be vigilant and investigate the exact neurologic examination and the imaging studies for HCC patients with disturbance of cranial nerve.

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