Base of Skull Metastatic Adenocarcinoma from the Breast 23 Years after the Primary Diagnosis

Abstract

Breast cancer metastases to the base of the skull with concomitant infiltration into the paranasal sinuses and nasopharynx are exceptionally rare with only small numbers of reported literatures. Greenberg et al. in 1981 described five clinical syndromes with regards to the base of skull metastases and the clinical presentation of each syndrome related to its anatomical location. Often, metastases to the base of the skull remain asymptomatic until the lesion has increased to a considerable size causing bony destruction and impingement to the surrounding structures. When involving the paranasal sinuses or nasopharynx, the most common presenting symptoms mimic those of rhinosinusitis and, hence, may delay the accurate diagnosis. We are reporting a case of base of skull metastasis from breast carcinoma, 23 years after the primary diagnosis. To the best of our knowledge, our case is the first case to report latent metastasis of more than 20 years.

A review of the neurological complications of breast cancer

“…In patients with breast cancer, the rate of hematogenous skull metastases is higher in comparison with any other tumors. [ 42 ] As reported by Othman et al ,[ 43 ] in the early stage of the disease, in about half of the breast cancer patients, bone metastases can be detected by 99 mTc scintigraphy. Anyway, many of these lesions do not become symptomatic and it could be estimated that these lesions allow the other complications to slowly develop breast cancer.…”