1
|
Muhammad-Ikmal MK, Masnon NA, Hayati F, Wan HItam WH. Sino-orbital metastasis as the initial presentation of advanced breast cancer. BMJ Case Rep 2022; 15:e250108. [PMID: 36368736 PMCID: PMC9660501 DOI: 10.1136/bcr-2022-250108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A woman in her 70s presented with reduced vision in her left eye, progressive narrowing of right eye opening for 6 months and anosmia. On examination, she had right enophthalmos and pseudoptosis with inferior globe dystopia. Her visual acuity was 6/9 and nil light perception in the right and left eyes, respectively. Extraocular muscle examination showed limited right up gaze. Funduscopy showed a normal right optic disc and left optic disc atrophy. Systemic examination revealed left breast ulceration with skin tethering. CT revealed an infiltrative mass invading the ethmoidal sinuses, frontal sinuses and both orbits. A histological diagnosis of infiltrative ductal breast carcinoma was made after nasal endoscopic and left breast biopsy. She underwent palliative chemoradiotherapy and survived with good disease control after 1 year. Metastatic carcinoma is a differential diagnosis of a sino-orbital mass, and comprehensive clinical assessment is indicated for all patients presenting with non-acute eye injury.
Collapse
Affiliation(s)
- Mohamad Kamil Muhammad-Ikmal
- Department of Ophthalmology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Nurul Ain Masnon
- Department of Ophthalmology and Visual Sciences, Universiti Sains Malaysia - Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Firdaus Hayati
- Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Wan-Hazabbah Wan HItam
- Department of Ophthalmology and Visual Sciences, Universiti Sains Malaysia - Health Campus, Kubang Kerian, Kelantan, Malaysia
| |
Collapse
|
2
|
Syamala DD, Reddy Kalluri PR, Singh HK, Ganne P. Superior Orbital Fissure Syndrome in a Case of Breast Cancer. Neuroophthalmology 2022; 46:343-346. [PMID: 36337231 PMCID: PMC9635536 DOI: 10.1080/01658107.2022.2034889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Metastasis from breast cancer to the head and neck region is a rare occurrence. However, of all the cancers that metastasise to the orbit, breast cancer is the leading cause in women. Usually, breast cancer metastasises to the fat and muscles in the orbit, and involvement of the bony orbital wall is rare. We report a case of a 52-year-old woman who presented with metastasis to the left greater wing of the sphenoid and adjacent squamous temporal bone. Ophthalmoplegia and proptosis were the initial manifestations in this patient, which lead to the diagnosis of the underlying breast cancer.
Collapse
Affiliation(s)
| | | | - Hemant Kumar Singh
- Department of Surgical Oncology, All India Institute of Medical Sciences, Guntur, India
| | - Pratyusha Ganne
- Department of Ophthalmology, All India Institute of Medical Sciences, Guntur, India,CONTACT Pratyusha Ganne Department of Ophthalmology, All India Institute of Medical Sciences, Mangalagiri, Guntur522503
| |
Collapse
|
3
|
Sellami M, Kallel S, Ben Ayed M, Mellouli M, Boudawara TS, Mnejja M, Hammami B, Achour I, Charfeddine I. Nasopharyngeal Metastasis from Breast Carcinoma: A Case Report and a Review of the Literature. EAR, NOSE & THROAT JOURNAL 2022:1455613221119047. [PMID: 35943955 DOI: 10.1177/01455613221119047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Metastasis to the nasopharynx is a rare clinical entity. Breast carcinoma is one of the primary tumors that can be responsible for a nasopharyngeal metastasis, which is an extremely rare occurrence. We report the case of a 50-year-old woman with a history of a confirmed breast carcinoma under chemotherapy who presented to our department with a unilateral hearing loss and tinnitus. Nasal endoscopy revealed a small bulging mass at the posterior wall of the nasopharynx. The biopsy of the lesion showed an infiltration of the nasopharyngeal mucosa by a mammary adenocarcinoma that was positive for estrogen and progesterone receptors and negative for human epidermal growth factor receptor 2. Computed tomography scan revealed a thickening of the nasopharyngeal mucosa, a pleural and pericardial effusion and diffused secondary bone lesions. The patient received chemotherapy. Control revealed a partial regression of the nasopharyngeal mass. The patient is still under chemotherapy.
Collapse
Affiliation(s)
- Moncef Sellami
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
- Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Souha Kallel
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
- Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Mariam Ben Ayed
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
- Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Manel Mellouli
- Sfax Medical School, University of Sfax, Sfax, Tunisia
- Department of Pathology and Research Laboratory LR18SP10, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Tahya Sellami Boudawara
- Sfax Medical School, University of Sfax, Sfax, Tunisia
- Department of Pathology and Research Laboratory LR18SP10, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Malek Mnejja
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
- Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Bouthaina Hammami
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
- Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Imen Achour
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
- Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Ilhem Charfeddine
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
- Sfax Medical School, University of Sfax, Sfax, Tunisia
| |
Collapse
|
4
|
Iqneibi S, Nazzal J, Amoudi R, Owda B, Al-Ibraheem A, Yaser S, Al-Hussaini M. Metastatic pulmonary adenocarcinoma to the nasopharynx at first clinical presentation: A case report and review of literature. SAGE Open Med Case Rep 2020; 8:2050313X20939826. [PMID: 32728442 PMCID: PMC7364794 DOI: 10.1177/2050313x20939826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 06/14/2020] [Indexed: 12/24/2022] Open
Abstract
Metastatic carcinomas in the nasopharynx are a rarity. We report a case of a 54-year-old male patient who presented with a history of recurrent epistaxis. On evaluation, a mass in the right Rosenmüller fossa was detected, which was biopsied and diagnosed as a poorly differentiated adenocarcinoma, immunoreactive for thyroid transcription factor-1, consistent with metastatic pulmonary adenocarcinoma. Fluorodeoxyglucose–positron emission tomography/computed tomography (FDG-PET/CT) scan confirmed the presence of a mass in the upper lobe of the left lung, proven pathologically to be a poorly differentiated pulmonary adenocarcinoma, with an immunoprofile similar to the nasopharyngeal tumor. The patient underwent palliative chemotherapy, and was then shifted to immunotherapy. He is currently alive and disease free 50 months after the initial diagnosis was made. The unusual presentation of a metastatic carcinoma in the nasopharynx will be discussed, along with a review of literature. The role of immunotherapy in cancer control and greater longevity will also be presented.
Collapse
Affiliation(s)
- Shahad Iqneibi
- Faculty of Medicine, University of Jordan, Amman, Jordan
| | - Jamil Nazzal
- Faculty of Medicine, University of Jordan, Amman, Jordan
| | - Runa Amoudi
- Faculty of Medicine, University of Jordan, Amman, Jordan
| | - Basma Owda
- Faculty of Medicine, University of Jordan, Amman, Jordan
| | - Akram Al-Ibraheem
- Departments of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Sameer Yaser
- Departments of Medical Oncology, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Maysa Al-Hussaini
- Departments of Pathology and Laboratory Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
| |
Collapse
|
5
|
Xiong J, Chen J, Zheng L, Yang S, Zhao G, Cheng J. Rare metastasis to paranasal sinuses from triple-negative breast cancer: A case report and literature review. Medicine (Baltimore) 2017; 96:e8718. [PMID: 29381961 PMCID: PMC5708960 DOI: 10.1097/md.0000000000008718] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Breast cancer, the most common form of cancer among women, rarely metastases to the head and neck region. To date, there have been only 6 similar cases in the literature, and most patients in these reports had very poor prognosis. PATIENTS CONCERNS We report a 61-year-old female presented pain and numbness on the right side of the face 5 years after being diagnosed with triple-negative breast cancer. DIAGNOSIS Magnetic resonance imaging (MRI) revealed a tissue mass in the sphenoid sinus. The tissue biopsy confirmed metastasis of breast cancer. INTERVENTION The patient received initial chemotherapy and radiotherapy plus 10 cycles of maintenance chemotherapy OUTCOMES:: The patient got long-term progression-free survival time. The total time to progression was 32 months. LESSONS Although breast cancer rarely metastasizes to the head and neck region, awareness should be raised when breast cancer patients experience headache or have sinus-related symptoms. Chemotherapy and radiotherapy may be effective to treat paranasal sinus metastasis of triple-negative breast cancer, and patients may achieve long-term survival.
Collapse
Affiliation(s)
| | | | - Liduan Zheng
- Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei province, China
| | | | | | | |
Collapse
|
6
|
A Unique Case of Muscle-Invasive Metastatic Breast Cancer Mimicking Myositis. Case Rep Oncol Med 2017; 2017:2648296. [PMID: 28744384 PMCID: PMC5506483 DOI: 10.1155/2017/2648296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 05/20/2017] [Accepted: 05/24/2017] [Indexed: 12/27/2022] Open
Abstract
Breast cancer rarely metastasizes to the muscles, and it is even more unusual for this phenomenon to result in airway compromise. We present a unique case of an 84-year-old female who presented with neck swelling and upper airway obstruction due to metastatic breast cancer invading the sternocleidomastoid muscles. After establishing the diagnosis and discussing possible treatment options, the patient elected for antiestrogen therapy, palliative tracheostomy, radiation therapy, and hospice services.
Collapse
|
7
|
López F, Devaney KO, Hanna EY, Rinaldo A, Ferlito A. Metastases to nasal cavity and paranasal sinuses. Head Neck 2016; 38:1847-1854. [PMID: 27218239 DOI: 10.1002/hed.24502] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2016] [Indexed: 12/19/2022] Open
Abstract
The sinonasal cavities are rare locations for metastases. Metastases to these locations are usually solitary and produce similar symptoms to those of a primary sinonasal tumor. Nasal obstruction and epistaxis are the most frequent symptoms. The maxillary sinus is most frequently involved. The most common primary tumor sites to spread to this region originate in the kidney, breast, thyroid, and prostate, although any malignancy could potentially lead to a metastasis to the paranasal sinuses. The patient's prognosis is usually poor because of the fact that the sinonasal metastasis is usually associated with widespread disseminated disease. In the majority of patients, palliative therapy is the only possible treatment option. Nevertheless, whenever possible, surgical excision either alone or combined with radiotherapy may be useful for palliation of symptoms and, rarely, to achieve prolonged survival. This review considers the most interesting cases reported in the literature that presents metastases to the sinonasal cavities. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1847-1854, 2016.
Collapse
Affiliation(s)
- Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.,University of Oviedo. Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | | | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group
| |
Collapse
|
8
|
Copson B, Pratap U, McLean C, Hayes T. Nasopharyngeal metastasis of breast carcinoma with HER 2 discordance: a case report. ANZ J Surg 2016; 88:508-509. [PMID: 26909745 DOI: 10.1111/ans.13446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Bridget Copson
- Department of Otolaryngology, Alfred Health, Melbourne, Victoria, Australia
| | - Upasna Pratap
- Department of Otolaryngology, Alfred Health, Melbourne, Victoria, Australia
| | - Catriona McLean
- Department of Anatomical Pathology, Alfred Health, Melbourne, Victoria, Australia
| | - Theresa Hayes
- Department of Medical Oncology, South West Oncology, Warrnambool, Victoria, Australia
| |
Collapse
|
9
|
Pittoni P, Di Lascio S, Conti-Beltraminelli M, Valli MC, Espeli V, Bongiovanni M, Richetti A, Pagani O. Paranasal sinus metastasis of breast cancer. BMJ Case Rep 2014; 2014:bcr-2014-205171. [PMID: 24973353 DOI: 10.1136/bcr-2014-205171] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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.
Collapse
Affiliation(s)
- P Pittoni
- Radiation Oncology, Oncology Institute of Southern Switzerland, Bellinzona-Lugano CH
| | - S Di Lascio
- Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona CH
| | - M Conti-Beltraminelli
- Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona CH Institute of Pathology, Locarno, Switzerland
| | - M C Valli
- Radiation Oncology, Oncology Institute of Southern Switzerland, Bellinzona-Lugano CH Institute of Pathology, Locarno, Switzerland Centro di Senologia della Svizzera Italiana, Bellinzona-Lugano CH
| | - V Espeli
- Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona CH
| | | | - A Richetti
- Radiation Oncology, Oncology Institute of Southern Switzerland, Bellinzona-Lugano CH Institute of Pathology, Locarno, Switzerland Centro di Senologia della Svizzera Italiana, Bellinzona-Lugano CH
| | - O Pagani
- Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona CH Institute of Pathology, Locarno, Switzerland
| |
Collapse
|
10
|
Johnston J, George M, Karkos PD, Dwivedi RC, Leong SC. Late metastasis to macroscopically normal paranasal sinuses from breast cancer. Ecancermedicalscience 2013; 7:298. [PMID: 23589727 PMCID: PMC3622408 DOI: 10.3332/ecancer.2013.298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Indexed: 11/23/2022] Open
Abstract
Background: Breast cancer can very rarely result in late metastases to the paranasal sinuses. Methods and results: We present a 75-year-old woman who developed sinonasal symptoms mimicking sinusitis 20 years after receiving a breast cancer diagnosis. Rigid nasendoscopy was unremarkable, but due to persistent unilateral nasal symptoms and suspicious radiological findings, the patient underwent endoscopic biopsies of macroscopically normal sinuses which confirmed metastatic breast cancer. Conclusions: High suspicion index, a thorough history, and examination are of paramount importance as metastases to the sinuses from breast cancer can occur even 20 years after diagnosis.
Collapse
Affiliation(s)
- James Johnston
- Department of Otolaryngology, Queen Alexandra Hospital, Southwick Hill Road, Portsmouth, UK
| | | | | | | | | |
Collapse
|