Kondoh Takeshi, Lee Kana, Higashino Masashi, Mizowaki Takashi, Tanaka Hirotomo, Takaishi Yoshiyuki
Neurosurgery, Shinsuma General Hospital, Kobe, JPN.
Otolaryngology, Shinsuma General Hospital, Kobe, JPN.
Cureus. 2023 Sep 1;15(9):e44551. doi: 10.7759/cureus.44551. eCollection 2023 Sep.
A 73-year-old female developed right facial paralysis of House-Brackmann (H-B) grade III and was diagnosed with Bell's palsy. After three months of steroid therapy, she developed progressive hearing loss, and an MRI revealed a tumor in the right internal auditory canal. Within a few months, the right facial nerve palsy recurred, and the patient was treated with Gamma Knife radiosurgery. The tumor in the irradiated region disappeared, but new dysphagia was observed, and a right parotid gland tumor was detected for the first time. Tumors of the right parotid gland and the digastric muscle of the jaw were surgically resected, and a diagnosis of diffuse large B-cell lymphoma was made. The tumor had invaded the cranial nerves and brainstem region, and the patient did not wish to undergo further medical therapy. This was a case of malignant lymphoma that started as facial paralysis and invaded the brainstem, and testing for possible lymphoma at an early stage prior to radiotherapy was desirable.
一名73岁女性出现House-Brackmann（H-B）Ⅲ级右侧面瘫，被诊断为贝尔麻痹。接受三个月的类固醇治疗后，她出现进行性听力丧失，磁共振成像（MRI）显示右侧内耳道有一个肿瘤。几个月内，右侧面神经麻痹复发，患者接受了伽玛刀放射外科治疗。照射区域的肿瘤消失，但出现了新的吞咽困难，并且首次检测到右侧腮腺肿瘤。手术切除了右侧腮腺和下颌二腹肌的肿瘤，诊断为弥漫性大B细胞淋巴瘤。肿瘤已侵犯颅神经和脑干区域，患者不希望接受进一步的药物治疗。这是一例始于面瘫并侵犯脑干的恶性淋巴瘤病例，在放疗前早期检测可能的淋巴瘤是可取的。
