Lung adenocarcinoma with initial symptom of occipital condyle syndrome – a case report

Background: A metastasis to the basilar bones, including the occipital bone, is extremely rare.Such metastases can result in hypoglossal nerve dysfunction, which poses dia gnostic challenges.We report a case of lung cancer presenting with hypoglossal nerve dysfunction caused by metastasis to the posterior condyle of the occipital bone.Case: A 52-year-old man was referred to our hospital due to hypoglossal nerve dysfunction and occipital pain.Imaging studies revealed a metastatic lesion in the posterior condyle of the occipital bone and a 12-mm nodule in the apex of the left lung.Histopathological analysis confirmed stage IVB lung adenocarcinoma without actionable driver mutations or significant PD-L1 expression.The patient underwent radiation therapy targeting the occipital lesion, fol lowed by systemic therapy with carboplatin, paclitaxel, bevacizumab, and atezolizumab.Maintenance therapy with bevacizumab and atezolizumab was continued.After 20 months of fol low-up, the patient remained dis ease-free, with resolution of hypoglossal nerve dysfunction.Imaging confirmed ossification at the site of the bone metastasis, indicating a favorable response to treatment. Conclusion:Although such cases are extremely rare, this report provides valuable insight into the management of patients with similar metastases.Early dia gnosis and a multidisciplinary approach, including chemotherapy, immunotherapy, and radiation therapy, are essential for improving outcomes in patients with rare metastases involving the posterior condyle of the occipital bone. Key wordsoccipital condyle syndrome -occipital bone -hypoglossal nerve dis eases -adenocarcinoma of lung -skull base neoplasms -bone metastasis -immune checkpoint inhibitorsradiotherapyThe authors declare that they have no potential conflicts of interest concerning drugs, products, or services used in the study.Autoi deklaruj, e v souvislosti s pedmtem studie nemaj dn komern zjmy.