Paranasal sinus metastasis of breast cancer

Abstract

A 76-year-old woman presented with symptoms suggestive of acute sinusitis. Previously, her breast carcinoma was treated with right lumpectomy, adjuvant chemotherapy and breast radiotherapy. She remained free from recurrence for the following 8 years. After initial treatment with antibiotics, the local symptom worsened with exophthalmos, eye blindness and development of an ulceration of the hard palate. MRI showed irregular enhancement of the nasal cavity extended to the maxillary sinus and ethmoidal lamina and concomitant infiltration of the orbit and skull base. A biopsy of the palatal ulcer showed a poorly differentiated adenocarcinoma and was compared with the histology of the primary breast tumour and it was concluded for the same morphology. After discussion at the multidisciplinary team, a specific chemotherapy has been activated with an initial local response. Further surgical resection was not thought appropriate and the patient has subsequently undergone palliative radiotherapy to the right paranasal lesions to improve local disease control.

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

“…The affected patients may remain asymptomatic for a long period; hence, early diagnosis is considered difficult. In the literature, the interval between the diagnosis of breast cancer and paranasal metastasis has been reported to range from 3 months to 20 years [ 2 , 3 ]. There was no reported case of base of skull metastasis from the breast for more than 20 years.…”

“…Specifically, in the case of breast cancer primary, the route of spread from the infiltrating ductal carcinoma of the breast to the sphenoid sinus is suspected to be hematogenous, while symmetrical ethmoid metastasis is suggested to be via transcribrosal spread [ 3 , 14 ].…”

Metastatic Tumors of the Sinonasal Cavity: A 15-Year Review of 17 Cases

“…Sinonasal metastases from distant extranasal sites is exceedingly rare. In the literature, nearly half of sinonasal metastases originated from the kidneys, followed by the lungs, breasts, colon, prostate, urogenital ridge, gastrointestinal tract, thyroid, and pancreas (Table 4) [1,5,9,12,13,14,15,16,17,18,19]. In our study, there were four sinonasal metastatic cases originating from the stomach and three cases from the liver, making gastrointestinal adenocarcinoma and hepatocellular carcinoma the top two common primary tumors.…”

Fibrosarcoma arising in the paranasal sinus: a clinicopathological and radiological analysis

“…38 Metastases to the nasal cavity and paranasal sinuses are uncommon. 39 They usually involve a history of malignancy, and the imaging findings vary according to the primary lesion type. 39,40 It is very important for radiologists to know the advantages and disadvantages of different imaging modalities.…”

“…39 They usually involve a history of malignancy, and the imaging findings vary according to the primary lesion type. 39,40 It is very important for radiologists to know the advantages and disadvantages of different imaging modalities. Basically, CT can only show the lesion, and give it some basic hard tissue description, size and delineation.…”