Mickel R A, Zimmerman M C
Division of Head and Neck Surgery, UCLA School of Medicine.
Otolaryngol Head Neck Surg. 1990 Jun;102(6):709-16. doi: 10.1177/019459989010200614.
While metastatic tumors to the nose and the paranasal sinuses overall are unusual, metastasis to the sphenoid sinus is exceedingly rare. Presented are 26 cases of metastasis to the sphenoid sinus. Seven were treated at UCLA between 1955 and 1988, and 19 additional cases were discovered from a search of the medical literature. The patients ranged from 14 months to 79 years of age. The most common tumor sites from which sphenoid metastases arose were the prostate and the lung. In 11 of the 26 cases, the sphenoid sinus metastasis was the first presentation of malignancy. Patients manifested signs and symptoms that were indistinguishable from those from primary tumors of the sinus. They included headache, facial pain, visual changes, and single or multiple cranial neuropathies. While cure of patients with sphenoid metastasis has not been reported, significant palliation with resolution of morbidity is possible in many patients with radiation therapy. Although metastasis to the sphenoid sinus is an uncommon entity, when present, signs and symptoms relating to this metastasis are frequently the first presentation of disease. As such, patients with sphenoid sinus symptoms suggestive of sphenoid sinus malignancy should be vigorously evaluated for the possibility of primary as well as metastatic tumor of the sinus.
虽然总体而言，转移至鼻和鼻窦的肿瘤并不常见，但转移至蝶窦的情况极为罕见。本文报告了26例蝶窦转移瘤病例。其中7例于1955年至1988年在加州大学洛杉矶分校接受治疗，另外19例是通过检索医学文献发现的。患者年龄从14个月至79岁不等。蝶窦转移瘤最常见的原发肿瘤部位是前列腺和肺。在26例病例中，有11例蝶窦转移瘤是恶性肿瘤的首次表现。患者表现出的体征和症状与鼻窦原发性肿瘤难以区分。这些症状包括头痛、面部疼痛、视力变化以及单发性或多发性颅神经病变。虽然尚未有蝶窦转移瘤患者治愈的报道，但许多患者通过放射治疗可实现显著缓解并减轻病痛。尽管蝶窦转移瘤并不常见，但一旦出现，与这种转移相关的体征和症状往往是疾病的首发表现。因此，对于有蝶窦症状提示蝶窦恶性肿瘤的患者，应积极评估鼻窦原发性肿瘤以及转移瘤的可能性。
