Frontal sinus adenocarcinoma

Abstract

a b s t r a c tCONTEXT: Paranasal sinus cancer is considered rare, with an incidence of less than 1 per 100,000 per year, with the frontal sinus being the primary site in only 0.3%. We report a case of adenocarcinoma arising in the frontal sinus. DESIGN:Case report. CASE REPORT:A 59-year-old woman, secretary, came in February 1998 with a 4-month history of low intensity frontal headache. She denied contact with wood dust. On examination a non-tender swelling was noted over her right forehead next to the medial aspect of the right orbit. CT scan showed a soft-tissue mass involving frontal sinus with intracranial invasion through the posterior wall. The anterior ethmoid sinus and the medial aspect of the right orbit were also involved. MRI demonstrated dural thickening in communication with the frontal mass. She underwent an en-bloc tumor resection by craniotomy including orbital clearance. Histology revealed an adenocarcinoma. After surgery she had tumor recurrence, and chemotherapy and radiotherapy were started resulting in partial improvement.

Primary squamous cell carcinoma of the frontal sinus

“…Standard treatments including surgical resection, radiation therapy, and chemotherapy, used singly or in combination, have failed to produce favorable outcomes in patients with frontal sinus tumors. Because the anatomy of the frontal sinus is complex, at the time of their detection, these tumors tend to be advanced and radical resection is technically difficult 3,4 . Consequently, the prognosis of patients with frontal sinus carcinoma remains extremely poor.…”

“…Approximately 3% of all head and neck cancers originate in the nasal/paranasal sinuses; the annual incidence is 1–3 cases per 100 000 population. Paranasal sinus carcinoma arising in the frontal sinus constitutes 0.3–1.0% of all paranasal sinus carcinomas 1–5 . Traditionally, these patients are treated by neurosurgeons or otorhinolaryngologists.…”

Metastasis of prostate adenocarcinoma to the frontal and ethmoid sinus

“…[5,6] While prostate cancer most frequently metastasizes to the bony tissue, visceral organs like the lungs, liver, and adrenal gland, also tertiary lymph nodes in the supraclavicular and mediastinal areas can also be affected. [2,6] In autopsies performed on patients with prostate cancer, incidence rates of intracranial metastasis have been found to vary between 4.2 and 4.4 percent.…”

“…[4,8] Malignant tumors of the nose and paranasal sinus constitute less than 1% of all malignant tumors of the head and neck. [5] Only 1% of the malignant tumors of the nose and paranasal sinus-the majority of which is primary squamous cell carcinoma-is metastatic. Tumors that most frequently show metastasis to the paranasal sinuses are hypernephroma, pulmonary, thoracic, gastrointestinal tract, adrenal cancers, skin melanoma, thyroid, pancreatic cancer, and seminoma.…”

“…Orbital symptoms can be diplopia, loss of vision, exophthalmos, blepharedema, and ptosis. [1,3,5] These symptoms may not clearly indicate malignancy every time. The first symptom of metastasis to the paranasal sinus can be an infection.…”