Haymes Adam, Mahalingam Sridhayan, Choudhury Natasha
Department of ENT, East Surrey Hospital, Redhill, Surrey, UK.
Department of ENT, Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells, Kent, UK.
BMJ Case Rep. 2017 Aug 3;2017:bcr-2017-219527. doi: 10.1136/bcr-2017-219527.
The metastatic spread of infraclavicular malignancies to the nasal cavity is rare. We describe the case of a 58-year-old man who presented with a 4-month history of right-sided rhinorrhoea, maxillary hypoesthesia, hyposmia and hypogeusia. Clinical examination revealed an irregular mass within the right nasal cavity. Immunohistochemical analyses of biopsies were consistent with small cell carcinoma of indeterminate origin. A positron emission tomography scan demonstrated extensive mediastinal lymphadenopathy with collapse-consolidation of the right lung's middle lobe and no other sites of metastasis. Following discussion at the lung multidisciplinary team meeting, a diagnosis of metastatic small cell lung cancer (SCLC) was made; the patient was staged with N3, M1b disease and palliative chemo-radiotherapy was started. To the best of our knowledge, this report represents the first documented case of a solitary nasal cavity metastasis arising from a SCLC.
锁骨下恶性肿瘤转移至鼻腔的情况罕见。我们报告一例58岁男性患者，有4个月的右侧鼻漏、上颌部感觉减退、嗅觉减退和味觉减退病史。临床检查发现右侧鼻腔内有一不规则肿块。活检的免疫组化分析结果与来源不明的小细胞癌相符。正电子发射断层扫描显示广泛的纵隔淋巴结肿大，右肺中叶实变不张，无其他转移部位。在肺部多学科团队会议讨论后，诊断为转移性小细胞肺癌（SCLC）；患者分期为N3、M1b期，并开始进行姑息性放化疗。据我们所知，本报告是首例有记录的由SCLC引起的孤立性鼻腔转移病例。
