Sino-orbital metastasis as the initial presentation of advanced breast cancer

A woman in her 70s presented with reduced vision in her left eye, progressive narrowing of right eye opening for 6 months and anosmia. On examination, she had right enophthalmos and pseudoptosis with inferior globe dystopia. Her visual acuity was 6/9 and nil light perception in the right and left eyes, respectively. Extraocular muscle examination showed limited right up gaze. Funduscopy showed a normal right optic disc and left optic disc atrophy. Systemic examination revealed left breast ulceration with skin tethering. CT revealed an infiltrative mass invading the ethmoidal sinuses, frontal sinuses and both orbits. A histological diagnosis of infiltrative ductal breast carcinoma was made after nasal endoscopic and left breast biopsy. She underwent palliative chemoradiotherapy and survived with good disease control after 1 year. Metastatic carcinoma is a differential diagnosis of a sino-orbital mass, and comprehensive clinical assessment is indicated for all patients presenting with non-acute eye injury.

[1]  Aaditya Prakash,et al.  A Rare Case of Metastases to Paranasal Sinus From Colonic Adenocarcinoma , 2021, Cureus.

[2]  Singh Vk.  Sinonasal Metastasis: A Clinico-pathological Series of Seven Cases , 2020 .

[3]  E. Mori,et al.  Metastasis of Papillary Thyroid Carcinoma to the Maxillary Sinus: Case Report and Review of the Literature , 2020, Case reports in otolaryngology.

[4]  C. Smart,et al.  Rare sites of breast cancer metastasis: a review , 2019, Translational cancer research.

[5]  M. Chang,et al.  Metastatic Tumors of the Sinonasal Cavity: A 15-Year Review of 17 Cases , 2019, Journal of clinical medicine.

[6]  A. Zakaria,et al.  Breast Cancer with Isolated Metastatic Temporomandibular Joint: A Surgeon’s Challenge , 2018, Borneo Journal of Medical Sciences (BJMS).

[7]  A. Giuliano,et al.  Breast cancer lung metastasis: Molecular biology and therapeutic implications , 2018, Cancer biology & therapy.

[8]  S. Reitsma,et al.  Metastasis of breast carcinoma to the paranasal sinus: report of two cases and systematic review of literature , 2018 .

[9]  R. Allen.  Orbital Metastases: When to Suspect? When to biopsy? , 2018, Middle East African journal of ophthalmology.

[10]  J. Chen,et al.  Rare metastasis to paranasal sinuses from triple-negative breast cancer , 2017, Medicine.

[11]  M. Akram,et al.  Awareness and current knowledge of breast cancer , 2017, Biological Research.

[12]  F. Jakobiec,et al.  Periocular breast carcinoma metastases: correlation of clinical, radiologic and histopathologic features , 2017, Clinical & experimental ophthalmology.

[13]  Seahyoung Lee,et al.  A spleen tyrosine kinase inhibitor attenuates the proliferation and migration of vascular smooth muscle cells , 2017, Biological Research.

[14]  K. Devaney,et al.  Metastases to nasal cavity and paranasal sinuses , 2016, Head & neck.

[15]  Devin C. Flaherty,et al.  Breast Cancer in Male Adolescents and Young Adults , 2016, Annals of Surgical Oncology.

[16]  S. Parnes,et al.  Palliative Endoscopic Surgery for Sinonasal Metastases: A Case Report and Literature Review , 2015, Ear, nose, & throat journal.

[17]  M. Bongiovanni,et al.  Paranasal sinus metastasis of breast cancer , 2014, BMJ Case Reports.

[18]  A. Jemal,et al.  Breast cancer statistics, 2013 , 2014, CA: a cancer journal for clinicians.

[19]  S. Davey,et al.  A rare case of breast cancer metastasising to the nasopharynx and paranasal sinuses. , 2012, International journal of surgery case reports.

[20]  L. Barnes.  Metastases to the Head and Neck: An Overview , 2009, Head and neck pathology.

[21]  U. Zafar,et al.  Masses of nasal cavity, paranasal sinuses and nasopharynx: A clinicopathological study , 2006, Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India.