Peripheric facial paralysis as initial manifestation of occult metastatic neoplasia.

Peripheral facial paralysis is a relative common condition; it is mostly idiopathic, when it receives the name Bell’s palsy. However, we should be aware of the differential diagnosis with less common severe or potentially lethal diseases. Thus, there are cases in which facial paralysis is a manifestation of a temporal bone metastasis. This is a rare situation, although its incidence has apparently increased in recent years; its diagnosis may be delayed by lack of appropriate and prompt investigation by a specialist. In this article we report a case of a patient with peripheral facial paralysis as the first manifestation of a metastasis originating from a hidden tumor; we also review the literature on the case. We highlight this case due to the difficulty in making the diagnosis and its unfavorable outcome.