Kallel Souha, Sellami Moncef
Service ORL et Chirurgie Cervico-faciale, CHU Habib Bourguiba, Sfax, Tunisie.
Pan Afr Med J. 2017 Dec 6;28:297. doi: 10.11604/pamj.2017.28.297.13929. eCollection 2017.
We report a rare case of adenocarcinoma of the sphenoid sinus manifesting as extended skull base tumor. The patient included in the study was a 42-year old woman presenting with unilateral right symptomatology consisting of nasal obstruction, diplopia and hemifacial neuralgias. Clinical examination showed paralysis of the cranial nerve pairs V and VI. Brain scanner showed voluminous heterogeneous sphenoid and clival mass reaching the right cavernous sinus, with a peripheral tissue component at the level of the sphenoid sinus. Biopsy was performed under general anesthesia, through endonasal sphenoidotomy approach. Histological examination showed non-intestinal adenocarcinoma. The patient died due to impaired general condition occurred during examinations. Skull base adenocarcinomas mainly occur in the ethmoid bone. Sphenoid origin is exceptional. Radiological appearance is not specific and suggests malignancy. Diagnosis should be suspected in patients with aggressive tumor, even when it occurs in the midline skull base.
我们报告了一例罕见的蝶窦腺癌,表现为颅底扩展肿瘤。纳入本研究的患者是一名42岁女性,出现单侧右侧症状,包括鼻塞、复视和半侧面部神经痛。临床检查显示第V和第VI对脑神经麻痹。脑部扫描仪显示蝶骨和斜坡有大量不均匀肿块,延伸至右侧海绵窦,蝶窦水平有外周组织成分。在全身麻醉下,通过鼻内蝶窦切开术进行活检。组织学检查显示为非肠型腺癌。患者在检查期间因全身状况恶化而死亡。颅底腺癌主要发生在筛骨。起源于蝶窦的情况极为罕见。放射学表现不具有特异性,提示为恶性肿瘤。即使肿瘤发生在颅底中线,对于侵袭性肿瘤患者也应怀疑有诊断。