A case of hypoglossal nerve palsy with evolving cranial nerve involvement in renal cell carcinoma: a case report.

Shadi Shams, Abigail Broughton, Katrina Lambeth, Aditi Trivedi, Dehua Wang, Sun Choo, Katherine Dove

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Article in Journal of medical case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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7 authors.

Shadi ShamsDepartment of Pediatrics, University of California, San Diego, CA, 92093, USA. shshams@health.ucsd.edu.ORCID http://orcid.org/0000-0003-4334-2820

Abigail BroughtonSchool of Medicine, University of California, San Diego, CA, 92093, USA.

Katrina LambethDepartment of Pediatrics, University of California, San Diego, CA, 92093, USA.

Aditi TrivediDepartment of Pediatrics, University of California, San Diego, CA, 92093, USA.

Dehua WangDepartment of Pediatrics, University of California, San Diego, CA, 92093, USA.

Sun ChooDepartment of Pediatrics, University of California, San Diego, CA, 92093, USA.

Katherine DoveDepartment of Pediatrics, University of California, San Diego, CA, 92093, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRenal cell carcinoma is a rare pediatric solid tumor that typically presents with hematuria, abdominal mass, or flank pain. It is uncommon for renal cell carcinoma to manifest with headache and isolated extra-urogenital symptoms. We present, to our knowledge, the first case of renal cell carcinoma with bony metastases, presenting initially as isolated cranial nerve twelve palsy. Although bony metastases can occur in renal cell carcinoma, skull-based metastases and cranial neuropathies are exceedingly rare, especially in the pediatric population. CASE PRESENTATION: We describe the unusual presentation of renal cell carcinoma with bony skull-based metastases presenting initially as isolated hypoglossal nerve palsy, that progressed to multiple cranial neuropathies in a previously healthy 14-year-old female of Indian descent.

conclusionThe differential for hypoglossal nerve with evolving cranial nerves 9 and 10 involvement can be broad owing to the course of the nerve, the structures surrounding it, and its pathway. It is important for providers to include bony metastatic disease in the differential diagnosis for headaches with multiple cranial neuropathies.

Indexed as

Bone NeoplasmsCarcinoma, Renal CellHypoglossal NerveHypoglossal Nerve DiseasesKidney NeoplasmsAdolescentCranial Fossa, PosteriorFemaleHeadacheHumansChild neurologyGlossopharyngeal nerveHypoglossal nerveMultiple cranial neuropathiesRCCRenal cell carcinomaSkull base metastasis

Identifiers

PMID40170122

DOI10.1186/s13256-025-05193-3

PMCPMC11959765

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