CASE REPORT Garcin syndrome as the initial presentation of metastatic adenocarcinoma of the prostate

We describe an unusual case of metastasis of the skull base from prostate cancer. A 64-year-old man was referred for progressive cranial nerve palsies. Brain magnetic resonance imaging showed a metastatic tumor in the right petrous bone. He was presenting Garcin syndrome indicating involvement of the right III, IV, V, VI, VII, VIII, IX, X, and XII cranial nerves. The serum PSA level was 5118 ng/mL (standard threshold 4 ng/mL). A transrectal needle biopsy was performed, and poorly differentiated adenocarcinoma was detected in the prostate. Therefore, he was finally diagnosed with skull base metastasis of the prostate cancer. Androgen deprivation therapy and external beam radiation therapy to the skull base resulted in complete resolution of the cranial nerve palsies for more than 30 months. This is the first reported case of metastatic prostate cancer presenting as Garcin syndrome.