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Also, bone metastases of the skull base may damage LCN.[108] Intra-cranial neoplasms may be further divided into those located intra-cerebrally and those located extra-cerebrally. Among the extracranial neoplasms, ADAMTS12 those located just below the skull and those of the neck are differentiated. Intrinsic brain tumors may affect the nuclei or intra-parenchymatous nerve tracts. Malignant spread within the CSF space affects cranial nerves and nerve roots. Tumors affecting the cranial nerves outside the bony skull may spread in an antero-or retrograde fashion. Intra-cerebral neoplasms affecting nuclei of LCN include the posterior fossa ependymoma,[109] choroid plexus papilloma,[110] primary CNS lymphoma,[111] or rarely metastasis.[112] Extra-axial neoplasms affecting the LCN include cisternal meningeomas,[113] extra-axial cavernomas,[114] choroid plexus papillomas,[115] intracranial Schwannomas,[116] or metastasis.[117] Leptomeningeal carcinomatosis involving the LCN is less frequent than involvement of upper cranial nerves.[118] Suspected leptomeningeal carcinomatosis may not always be confirmed at autopsy. Usually, however, SB431542 chemical structure an autopsy in meningeal carcinomatosis may show squamous-type carcinoma cells scattered in the cerebro-spinal leptomeninges and perineurium of almost all spinal and cranial nerve roots, causing severe axonal degeneration.[119] Involvement of the leptomeninges in lymphomatoid granulomatosis may also damage LCN.[120] Bone metastases of the base of the skull, which are usually painful, are a frequent cause of LCN dysfunction including Collet-Sicard-syndrome.[108,121] The most frequent neoplasms of the jugular foramen are the paragangliomas,[113] followed by Schwannomas,[122] neuroendocrine carcinoma,[123] and meningeomas.[124] Paraganglioma accounts for Alpelisib order of the neck may even cause Collet-Sicard-syndrome.[22] Neoplasms originating from one of the LCN include the hypoglossal Schwannoma,[125] the vagal nerve Schwannoma,[126] and the neurilemmoma of the vagal nerve.[127] The base of the skull neoplasms affecting LCN include the hemangiopericytoma,[128] the glomus tumor,[129] chordomas,[130] osteosarcoma, or metastasis. Neoplasms of the neck may also injure LCN. Recurrent squamous carcinoma metastatic to the neck may directly infiltrate the glossopharyngeal or vagal nerves.[131] Neck fibrosarcoma as well as multiple myeloma, hypoglossal Schwannoma, jugular foramen neurinoma, jugular foramen metastatic melanoma, or hemangiopericytoma may cause Collet-Sicard-syndrome. Tonsillar carcinoma invading the parapharyngeal space may lead to hypersensitivity of the carotid sinus coupled with glossopharyngeal neuralgia.[132] LCN lesions may also originate from perineural spread of a facial squamous cell carcinoma.