Distant metastases to nasal cavities and paranasal sinuses, from the organs outside the head and neck
Journal Title: Otolaryngologia Polska - Year 2008, Vol 62, Issue 4
Abstract
Introduction. The metastases from below the clavicles, to the head and neck region, are relatively uncommon, and usually demonstrate during the progression of the primary disease. At that time, the correct diagnosis requires only to compare the pathology report from the primary biopsy, with the biopsy from the lump in the head and neck. The majority of distant metastases to the head and neck region are localized within the lymph nodes. The metastases to nasal cavity and paranasal sinuses are very rare and usually localized within the maxillary sinus. Material. 4 cases, out of 46 all distant metastases to the head and neck region, localized in the nasal cavity and paranasal sinuses, diagnosed and treated in Dept. of ORL H&N surgery, Holy Cross Cancer Centre, from 2001 to 2007. Methods. Case presentation, based on clinical documentation, and current follow up. Case I. F. 71 years; the metastasis of colonic carcinoma to the sphenoid sinus (as a first symptom of the disease). The palliative Rtg-therapy was applied, and patient died in 2 months after diagnosis was established. Case II. M. 69 y with metastasis of kidney cancer (Ca clarocellulare) to the nasal cavity, during a palliative stage of the disease due to multiple lung metastases. Patient was treated with multiple courses of chemotherapy due to generalization of the disease. The nasal cavity metastasis was treated with repeated local resections. At present with no metastasis within the head and neck region – alive, in relatively good condition, with 23 months of observation. Cases III. F. 50 years in palliative stage of the breast cancer, with metastases to the bones and hepar and with metastasis to the maxillary sinus. Received palliative Rtg. therapy on the region of metastasis. Died in 5 months after diagnosis of maxillary sinus metastasis. Case IV. F. 54 years in palliative stage of the colonic cancer, with multiple metastases to the lungs and hepar; with metastasis to the maxillary sinus. During hemotherapy a symptoms of tumor of the maxillary sinus appeared, confirmed as a metastasis. The palliative Rtg-therapy on the region of metastasis. Died in 18 months, after diagnosis of maxillary sinus metastasis. Conclusions. The prognosis of metastases from distant organs, to the nasal cavity and paranasal sinuses is miserable. In the majority of distant metastases to the nose and paranasal sinuses, the palliative therapy is the only possible option of treatment.
Authors and Affiliations
Bartłomiej Kamiński, Joanna Kobiorska-Nowak, Stanisław Bień
Keywords
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