[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-327097-105":59,"doc-detail-327097-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","unilateral-tongue-atrophy-as-the-initial-clinical-manifestation-in-a-patient-with-prostate-cancer","Unilateral tongue atrophy as the initial clinical manifestation in a patient with prostate cancer","","Unilateral tongue atrophy presented as the first clinical sign in a 54-year-old man later diagnosed with metastatic prostate cancer. He developed dysarthria and progressive limb weakness, followed by hypoglossal nerve paralysis features, marked left tongue atrophy, cranial base involvement, and skeletal lesions confirmed by CT and MRI. Elevated PSA supported acinar prostate adenocarcinoma, and hormone therapy was initiated given the poor prognosis. The case highlights the diagnostic challenge and the need to consider twelfth cranial nerve involvement in men over 40.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/unilateral-tongue-atrophy-as-the-initial-clinical-manifestation-in-a-patient-with-prostate-cancer/327097/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/unilateral-tongue-atrophy-as-the-initial-clinical-manifestation-in-a-patient-with-prostate-cancer/327097.png","ImageObject",300,407,{"name":92,"@type":93},"Finn","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is unilateral tongue atrophy important in this prostate cancer case?","Question",{"text":112,"@type":113},"It served as an initial, rare marker pointing to metastatic prostate cancer. The case emphasizes vigilance for cranial nerve involvement early in evaluation.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What symptoms led to the diagnosis?",{"text":117,"@type":113},"The patient developed dysarthria, tongue-related dysfunction, progressive weakness, urinary symptoms, and substantial weight loss. Examination suggested hypoglossal nerve paralysis with left tongue atrophy.",{"name":119,"@type":110,"acceptedAnswer":120},"How did imaging and lab tests confirm the underlying cause?",{"text":121,"@type":113},"CT and MRI identified diffuse lytic lesions at the skull base and findings consistent with cranial nerve involvement. Elevated PSA supported acinar prostate adenocarcinoma as the diagnosis.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},327097,1790883993,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":24,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},34359740700684,"https://ap-avatar.wpscdn.com/avatar/1f400023980c374ae676?_k=1777273430885731487","DOI: 10. 1002/ccr3 .8615  \nCASE REPORT  \nUnilateral tongue atrophy as the initial clinical manifestation in a patient with prostate cancer  \nMohammed Zahran1  | Henry Larios2  | Victor Rosales3  | Adrian Coulson1   \n1Neurology Department, Manolo Morales Peralta Hospital, Managua, Nicaragua  \n2Pathology Department, Manolo Morales Peralta Hospital, Managua, Nicaragua  \n3Nuclear Medicine Department, Nora Astorga Hospital, Managua, Nicaragua  \nCorrespondence  \nMohammed Zahran, Neurology Department, Manolo Morales Peralta Hospital, Managua, Nicaragua.  \nEmail: [blackestar.199@gmail.com](blackestar.199@gmail.com) and [blacke_star.1991@yahoo.com](blacke_star.1991@yahoo.com)  \nKey Clinical Message  \nUnilateral tongue atrophy can be a rare and crucial early indicator of metastatic prostate cancer, highlighting the need for vigilant monitoring in clinical assessments. This case underscores the importance of considering cranial nerve involvement, especially the twelfth, for timely intervention and comprehensive patient care.  \nAbstract  \nProstate cancer, ranking among the most prevalent cancers, often manifests with skeletal metastases. Cranial nerve involvement, particularly the twelfth cranial nerve (XII), as an initial presentation is exceptionally rare. This case report outlines a unique instance of unilateral tongue atrophy as the primary clinical manifestation in a patient diagnosed with metastatic prostate cancer. A 54-year-oldman presented with dysarthria and progressive weakness, later revealing signs of hypoglossal nerve paralysis, unilateral tongue atrophy, and skeletal metastases involving the base of the skull. Imaging studies, including CT and MRI, confirmed diffuse lytic lesions and cranial nerve entrapment. Further investigations identified elevated PSA levels, confirming acinar prostate adenocarcinoma. The patient underwent hormone therapy due to the poor prognosis. Prostate cancer's skeletal metastases are well-documented, but cranial nerve involvement remains rare, particularly with isolated XII nerve manifestation. The discussion emphasizes the diagnostic challenges, imaging techniques' roles, and the impact on prognosis and quality of life. This case underscores the rarity of unilateral XII nerve involvement as the initial presentation of metastatic prostate cancer. Clinicians should consider this manifestation, especially in men over 40, warranting a thorough diagnostic approach, including PSA measurement and referral for appropriate oncological and urological interventions.  \nKEYWORDS  \nacinar prostate adenocarcinoma, cranial nerve involvement, hypoglossal nerve paralysis, prostate cancer, skeletal metastases, unilateral tongue atrophy  \nThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.  \n© 2024 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.  \n2 of 5  \n|  \nZAHRAN et al.  \n1 | INTRODUCTION  \nOncological diseases continue to pose a significant burden on public health. Prostate cancer ranks as the third most common cancer overall and the second when differentiated by gender.1 This cancer often exhibits a high metastatic capacity, particularly to the skeletal system, with metastatic rates reaching up to 82%, accompanied by elevated PSA levels compared to other metastases.2 Although the spine, pelvis, and femur are common sites, involvement of the skull base, leading to cranial neuropathies, is rare.3 Unusually, the involvement of cranial nerves, particularly the twelfth cranial nerve (XII), has been described as an uncommon and rare initial manifestation of prostate cancer,4 which is the focus of our case.  \n2 | CASE PRESENTATION  \nFIGURE 1 (A) Patient with left tongue atrophy, arrow indicating protrusion (Image obtained with the patient's consent in the Neurology De","cbCait2R51aD2sx2","https://ap.wps.com/l/cbCait2R51aD2sx2","pdf",1388785,"English","# Case report overview\n## Key clinical message\n## Abstract\n## Introduction\n## Case presentation","[{\"question\":\"Why is unilateral tongue atrophy important in this prostate cancer case?\",\"answer\":\"It served as an initial, rare marker pointing to metastatic prostate cancer. The case emphasizes vigilance for cranial nerve involvement early in evaluation.\"},{\"question\":\"What symptoms led to the diagnosis?\",\"answer\":\"The patient developed dysarthria, tongue-related dysfunction, progressive weakness, urinary symptoms, and substantial weight loss. Examination suggested hypoglossal nerve paralysis with left tongue atrophy.\"},{\"question\":\"How did imaging and lab tests confirm the underlying cause?\",\"answer\":\"CT and MRI identified diffuse lytic lesions at the skull base and findings consistent with cranial nerve involvement. Elevated PSA supported acinar prostate adenocarcinoma as the diagnosis.\"}]","Unilateral tongue atrophy as the initial clinical manifestation in a patient with prostate cancer | PDF",1789976282,13]