乳腺癌鼻腔鼻窦颅底转移1例

Breast cancer with metastasis to the nasal cavity,paranasal sinusand skull base:a case report

目的探讨乳腺癌鼻腔鼻窦颅底转移性病变的临床诊治。方法回顾性分析收治的1例乳腺癌鼻腔鼻窦颅底转移性病变患者的临床病例资料,对该疾病的临床特点、诊断及治疗进行讨论。结果本例患者术前行CT、MRI检查示蝶窦内可见软组织影并骨质破坏,并给予抗感染等治疗,症状未见明显好转,患者在全麻鼻内镜下行鼻窦肿物切除术,术后病理结果示鼻窦肿物为乳腺癌转移性病变,建议患者行放射及化学治疗。结论乳腺癌是女性常见的恶性肿瘤之一,发生头颈部转移临床并不常见,尤其发生鼻腔鼻窦颅底转移极为罕见。因此需结合病史、临床症状、体格检查及相应的辅助检查等,做出正确的临床诊断并制定相应的治疗方案,防止鼻腔鼻窦颅底转移性病变的误诊漏诊。

Objective To explore the clinical diagnosis and treatment of metastatic lesions in the nasal cavity,paranasal sinus and skull base from breast cancer.Methods The clinical data of a case of breast cancer with metastatic lesions in nasal cavity,paranasal sinus and skull base were retrospectively analyzed,and the clinical characteristics,diagnosis and treatment of this disease were discussed.Results Preoperative CT and MRI examination showed that this patient had soft tissue shadows in the sphenoidal sinus and bone destruction.After anti-infection and other treatment,the patient’s symptoms were not significantly improved.Nasal endoscopic sinus neoplasm resection was performed under general anesthesia.The postoperative pathological results showed that the sinus neoplasm was metastatic carcinoma of breast cancer.Postoperative radiotherapy and chemotherapy were recommended for this patient.Conclusion Breast cancer is one of the most common malignant tumors in women.Head and neck metastases of breast cancer are not common clinically.In particular,metastasis to the nasal cavity and paranasal sinus base is extremely rare in breast cancer.Therefore,it is necessary to combine the medical history,clinical symptoms,physical examination and the corresponding auxiliary examination to make a correct clinical diagnosis and formulate the corresponding treatment,which will prevent misdiagnosis and misdiagnosis of the metastatic lesion in the nasal cavity,sinuses and skull base.