Baharudin Nazirah, Gendeh Hardip Singh, Hashim Muhammad Amir, Ahmad Fawzi Noor Elyana, Gnanasegaram Hemlata Kumari
Department of Otorhinolaryngology Head & Neck Surgery, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
Department of Otorhinolaryngology Head & Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Case Rep Oncol. 2025 Jul 8;18(1):1040-1049. doi: 10.1159/000546040. eCollection 2025 Jan-Dec.
Breast cancer (BC) is the most common cancer among women worldwide. While metastases typically affect the lungs, liver, and bones, spread to the paranasal sinuses, especially the sphenoid sinus, is extremely rare.
A 57-year-old woman with a history of infiltrative ductal carcinoma of the breast diagnosed 12 years earlier presented with progressive left-sided vision blurring and headaches for 3 weeks. Imaging revealed a heterogeneous lesion in the left sphenoid sinus compressing the optic nerve. The metastatic breast carcinoma with histopathological and immunohistochemical profiles matching the primary tumour was confirmed by biopsy. Because of the lesion's unresectable nature and additional metastases to the bones and lungs, palliative treatment was initiated, consisting of intensity-modulated radiation therapy and systemic therapy with abemaciclib and letrozole. After treatment, the patient's vision improved, and follow-up imaging showed reduced lesion size.
Metastasis of BC in the sphenoid sinus is rare; it can occur even after a prolonged remission period. This case highlights the need for maintaining a high index of suspicion in patients with a history of malignancy who present with unusual orbital or sinonasal symptoms. Early diagnosis prior to the multidisciplinary treatment approach can help to improve patient outcome.
乳腺癌（BC）是全球女性中最常见的癌症。虽然转移通常影响肺、肝和骨，但扩散至鼻窦，尤其是蝶窦极为罕见。
一名57岁女性，12年前被诊断为浸润性导管癌，出现进行性左侧视力模糊和头痛3周。影像学检查显示左侧蝶窦有一异质性病变压迫视神经。活检证实为转移性乳腺癌，其组织病理学和免疫组化特征与原发肿瘤相符。由于病变无法切除且伴有骨和肺的其他转移，开始进行姑息治疗，包括调强放射治疗以及使用阿贝西利和来曲唑的全身治疗。治疗后，患者视力改善，随访影像学检查显示病变大小减小。
BC转移至蝶窦罕见；即使在长期缓解期后也可能发生。本病例强调，对于有恶性肿瘤病史且出现异常眼眶或鼻窦症状的患者，需保持高度怀疑。在多学科治疗方法之前进行早期诊断有助于改善患者预后。
