Lavasani Leela, Zapanta Philip E, Tanna Neil, Sadeghi Nader
Division of Otolaryngology-Head and Neck Surgery, George Washington University Medical Center, Washington, DC, USA.
Ann Otol Rhinol Laryngol. 2006 Sep;115(9):690-3. doi: 10.1177/000348940611500907.
The presentation, diagnosis, and management of prostatic adenocarcinoma metastatic to the sphenoid sinus are reviewed. We present a case report with a review of the literature. A 67-year-old man with a history of prostatic adenocarcinoma presented with gradual left visual loss. Magnetic resonance imaging revealed a lesion of the left orbital apex with extension into the ipsilateral sphenoid sinus. Operative biopsy of the lesion was significant for adenocarcinoma of the prostate. When an otolaryngologist encounters a mass in the sphenoid sinus, he or she needs to consider a diverse differential diagnosis. In evaluating possible causes, a history of malignancies should be elicited. Furthermore, the pathophysiology and potential routes of metastatic disease should be assessed for these primary neoplasms. Having a high level of suspicion for metastatic disease from specific primary sites will help guide the pathological evaluation. As in this clinical scenario of a patient with a history of prostatic adenocarcinoma, appropriate analysis would entail sending specimens for immunohistochemical staining, such as prostate-specific antigen and prostate-specific acid phosphatase. Correct diagnosis is crucial, as these patients may achieve remission and prolonged survival with irradiation and/or hormonal therapy.
本文回顾了蝶窦转移性前列腺腺癌的临床表现、诊断及治疗。我们报告了一例病例并对相关文献进行了综述。一名有前列腺腺癌病史的67岁男性出现渐进性左眼视力丧失。磁共振成像显示左侧眶尖有一病变，并延伸至同侧蝶窦。对该病变进行手术活检，结果显示为前列腺腺癌。当耳鼻喉科医生遇到蝶窦肿物时，需要考虑多种鉴别诊断。在评估可能的病因时，应询问恶性肿瘤病史。此外，还应评估这些原发性肿瘤转移疾病的病理生理学及可能途径。对特定原发部位的转移疾病保持高度怀疑将有助于指导病理评估。就像本例有前列腺腺癌病史的临床情况一样，适当的分析需要送检标本进行免疫组化染色，如前列腺特异性抗原和前列腺特异性酸性磷酸酶。正确诊断至关重要，因为这些患者通过放疗和/或激素治疗可能实现缓解并延长生存期。
