转移性上颌窦腺癌1例

Distant metastases to maxillary sinus from an unknown lung adenocarcinoma:a cases report

1病例报告患者,男,59岁,因＂左面部麻木、牙痛半年＂入院。吸烟史明确,既往史无特殊。常规检查心电图、X线胸片、腹部B超未见明显占位病变。鼻窦CT提示左侧上颌骨占位性病变,牙槽骨破坏明显,上颌窦内不均匀病变（图1）。入院诊断为上颌窦占位,于鼻内镜下钳夹病变组织,见下鼻道黏膜隆起,组织出血明显,含骨组织成分。第1次病理检查结果提示上颌窦癌,

Summary A 59-year-old man was admitted to the Department of Ear,Nose and Throat with a complaint of six-month history of left facial numbness and toothache.There was no special previous medical history in addition to smoking.No obvious abnormality in routine electrocardiogram,chest X-ray,abdominal B ultrasound were found.1CT scans showed heterogeneous shadows in maxillary sinus with the lesions on the left maxillary bone and evidently destruction of alveolar bone.The histopathological examination revealed bone tissue which was partly covered by an intact adenocarcinoma cell.2Immunohistochemical staining foe CK7,CD117,thyroid transcription factor-1,and novel aspartic proteinase A were positive and thus compatible with metastatic lung adenocarcinoma.3Chest CT scans showed a 1cm×2cm mass on the superior lobe of the left lung,with destruction of sternum and rib,confirming that the lesions in the paranasal sinuses were lung cancer metastases.Therefore,this patient conclusively diagnosed as lung adenocarcinoma with multiple bone metastases.