Conti Chiara, Nucera Sabrina, Di Grazia Giuseppe, Martorana Federica, Motta Fabio, Vigneri Paolo, Di Grazia Alfio M
Department of Human Pathology "G. Barresi", University of Messina, Messina, Italy.
Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Case Rep Oncol. 2024 Dec 5;17(1):1358-1365. doi: 10.1159/000539018. eCollection 2024 Jan-Dec.
Managing uncommon metastatic sites from different solid tumors is challenging since no available guidelines define the best therapeutic approaches for these rare clinical events. Thus, malignancies giving rise to distant metastases involving infrequent anatomical regions are often associated with a poor prognosis.
We present the case of a 75-year-old man who developed uncontrolled epistaxis following the detection of a metachronous nasopharyngeal metastasis from a previous lung adenocarcinoma. The lesion was identified with a computed tomography scan and its origin from the earlier non-small cell lung cancer was confirmed by a biopsy. The patient was successfully treated with radiation therapy and is currently continuing his oncological follow-up. To the best of our knowledge, this is the fifth reported case of a lung malignancy spreading to the nasopharyngeal region.
Meticulous patient monitoring and accurate radiological diagnosis followed by histological confirmation are of paramount importance for the management of uncommon metastatic sites. Likewise, a multidisciplinary approach is essential to devise the appropriate treatment strategy for each patient with locoregional interventions, such as radiation therapy, often playing a pivotal role for the management of symptomatic lesions in unusual anatomical sites.
由于没有可用的指南来定义针对这些罕见临床事件的最佳治疗方法，管理来自不同实体瘤的不常见转移部位具有挑战性。因此，导致远处转移累及不常见解剖区域的恶性肿瘤通常预后较差。
我们报告一例75岁男性病例，该患者在先前肺腺癌出现异时性鼻咽转移后发生无法控制的鼻出血。通过计算机断层扫描识别出病变，并经活检证实其起源于早期非小细胞肺癌。患者接受放射治疗后成功治愈，目前正在继续进行肿瘤学随访。据我们所知，这是第五例报道的肺恶性肿瘤扩散至鼻咽部的病例。
对于不常见转移部位的管理，细致的患者监测、准确的放射学诊断以及随后的组织学确认至关重要。同样，多学科方法对于为每位患者制定合适的治疗策略必不可少，局部区域干预措施，如放射治疗，通常在处理不寻常解剖部位的有症状病变中起关键作用。
