Pittoni P, Di Lascio S, Conti-Beltraminelli M, Valli M C, Espeli V, Bongiovanni M, Richetti A, Pagani O
Radiation Oncology, Oncology Institute of Southern Switzerland, Bellinzona-Lugano CH.
Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona CH.
BMJ Case Rep. 2014 Jun 27;2014:bcr2014205171. doi: 10.1136/bcr-2014-205171.
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.
一名76岁女性出现提示急性鼻窦炎的症状。此前，她的乳腺癌接受了右乳房肿块切除术、辅助化疗和乳房放疗。在接下来的8年里她一直没有复发。在最初使用抗生素治疗后，局部症状恶化，出现眼球突出、失明以及硬腭溃疡。磁共振成像显示鼻腔不规则强化，延伸至上颌窦和筛骨板，并伴有眼眶和颅底浸润。腭部溃疡活检显示为低分化腺癌，与原发性乳腺肿瘤的组织学进行比较，结论为形态相同。在多学科团队讨论后，启动了特定化疗，最初有局部反应。进一步的手术切除被认为不合适，患者随后接受了右侧鼻旁病变的姑息性放疗，以改善局部疾病控制。
