Tanaka Kohtaroh
Department of Otolaryngology, International Medical Center of Japan, Tokyo, Japan.
Int J Clin Oncol. 2006 Feb;11(1):64-5. doi: 10.1007/s10147-005-0531-8.
Metastases of malignancies to the sinonasal tract are rare. We report a case of metastases to the paranasal sinus from rectal adenocarcinoma. A 72-year-old woman, who had a history of therapy with rectal adenocarcinoma, came to our hospital for visual loss in her right eye. Computed tomography revealed soft tissue in the right paranasal sinus. She underwent endoscopic sinus surgery immediately and an easily bleeding tumor was found in the paranasal sinus. Magnetic resonance imaging showed a mass involving the posterior ethmoid, the sphenoid sinus, and the orbit. From the surgical specimen, we found that the tumor was a metastasis of a previously managed rectal mucinous adenocarcinoma. Metastatic carcinomas of the sinonasal tract have a high risk of heavy hemorrhage during endoscopic sinus surgery. When a patient with visual loss has a history of malignancy, a possible metastatic tumor should be considered before surgery.
恶性肿瘤转移至鼻窦区较为罕见。我们报告一例直肠腺癌转移至鼻窦的病例。一名72岁女性,有直肠腺癌治疗史,因右眼视力丧失前来我院就诊。计算机断层扫描显示右侧鼻窦有软组织。她立即接受了鼻内镜鼻窦手术,术中发现鼻窦内有一易出血的肿瘤。磁共振成像显示肿块累及后筛窦、蝶窦和眼眶。通过手术标本,我们发现该肿瘤是之前治疗过的直肠黏液腺癌的转移灶。鼻窦转移性癌在内镜鼻窦手术期间有大出血的高风险。当有视力丧失且有恶性肿瘤病史的患者就诊时,手术前应考虑可能存在转移性肿瘤。