Ergin Aydemir, Alper Türkel, Kübra Okur, Taylan Altıparmak, Mutlu Doğan
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Abstract
Background: Paclitaxel is a widely used chemotherapeutic agent for the treatment of breast cancer. While peripheral neuropathy is a well-recognized dose-limiting toxicity of paclitaxel, cranial nerve involvement remains exceptionally rare. We report a case of unilateral facial nerve palsy in a breast cancer patient receiving standard-dose paclitaxel therapy, highlighting the diagnostic challenges in distinguishing drug-induced neurotoxicity from other aetiologies.
Case report: A 43-year-old woman with metastatic breast cancer developed left facial nerve paralysis after 12 months of weekly paclitaxel treatment (80 mg/m2). Contrast-enhanced cranial Magnetic Resonance Imaging (MRI) demonstrated bilateral cranial nerve VII enhancement, creating diagnostic uncertainty between leptomeningeal metastasis, paclitaxel-induced neuritis, and idiopathic Bell's palsy. Paclitaxel was discontinued, and corticosteroid therapy was initiated. Clinical and radiological improvement at follow-up strongly supported a drug-related aetiology.
Conclusion: This case illustrates the diagnostic complexity of facial nerve palsy in cancer patients receiving neurotoxic chemotherapy. The overlapping clinical and radiological features between drug-induced cranial neurotoxicity, leptomeningeal disease, and idiopathic causes present significant diagnostic challenges. Clinicians should maintain a high degree of suspicion for rare chemotherapy-related cranial neuropathies while pursuing comprehensive differential diagnosis, including infectious aetiologies and metastatic disease.
期刊介绍：
The Journal of Chemotherapy is an international multidisciplinary journal committed to the rapid publication of high quality, peer-reviewed, original research on all aspects of antimicrobial and antitumor chemotherapy.
The Journal publishes original experimental and clinical research articles, state-of-the-art reviews, brief communications and letters on all aspects of chemotherapy, providing coverage of the pathogenesis, diagnosis, treatment, and control of infection, as well as the use of anticancer and immunomodulating drugs.
Specific areas of focus include, but are not limited to:
· Antibacterial, antiviral, antifungal, antiparasitic, and antiprotozoal agents;
· Anticancer classical and targeted chemotherapeutic agents, biological agents, hormonal drugs, immunomodulatory drugs, cell therapy and gene therapy;
· Pharmacokinetic and pharmacodynamic properties of antimicrobial and anticancer agents;
· The efficacy, safety and toxicology profiles of antimicrobial and anticancer drugs;
· Drug interactions in single or combined applications;
· Drug resistance to antimicrobial and anticancer drugs;
· Research and development of novel antimicrobial and anticancer drugs, including preclinical, translational and clinical research;
· Biomarkers of sensitivity and/or resistance for antimicrobial and anticancer drugs;
· Pharmacogenetics and pharmacogenomics;
· Precision medicine in infectious disease therapy and in cancer therapy;
· Pharmacoeconomics of antimicrobial and anticancer therapies and the implications to patients, health services, and the pharmaceutical industry.
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