A case of metastases to the paranasal sinus from rectal mucinous adenocarcinoma

Abstract

Metastases of malignancies to the sinonasal tract are rare. We report a case of metastases to the paranasal sinus from rectal adenocarcinoma. A 72-year-old woman, who had a history of therapy with rectal adenocarcinoma, came to our hospital for visual loss in her right eye. Computed tomography revealed soft tissue in the right paranasal sinus. She underwent endoscopic sinus surgery immediately and an easily bleeding tumor was found in the paranasal sinus. Magnetic resonance imaging showed a mass involving the posterior ethmoid, the sphenoid sinus, and the orbit. From the surgical specimen, we found that the tumor was a metastasis of a previously managed rectal mucinous adenocarcinoma. Metastatic carcinomas of the sinonasal tract have a high risk of heavy hemorrhage during endoscopic sinus surgery. When a patient with visual loss has a history of malignancy, a possible metastatic tumor should be considered before surgery.

Metastasis to the nasal cavity from primary rectal adenocarcinoma

“…Another, uncommon, origin is the gastrointestinal tract: stomach [1,4], colon [2], sigmoid [3,5] and rectum [6]. In order to correctly rule out a metastatic origin for sinonasal neoplasms, a detailed immunophenotyping of tumour cells is necessary.…”

“…Up to now only six cases of antral metastasis from carcinoma of the gastrointestinal tract have been described [1][2][3][4][5], with only one patient with metastasis to the paranasal sinus from rectal mucinous adenocarcinoma [6]. We describe the diagnostic process and the clinical outcome of a patient with metastasis in the nasal cavity and paranasal sinuses from a rectal cancer.…”

Neoplastic infiltration of the sphenoid wing: A rare manifestation of metastatic colorectal cancer

“…In one patient, sphenoid sinus invasion was the first symptom of the disease, 3 while in the other neoplastic dissemination became evident as a bleeding sino-nasal mass causing unilateral visual loss many years after the primary tumor had been treated. 4 The anatomical features of the region and the rarity of this occurrence make clinical management a challenge. Endoscopic sinus surgery has been suggested as a safe and adequate procedure to assess rhino sinal masses, with the advantage of being able to be performed on an outpatient basis.…”

“…In one of the previously described colorectal metastases endonasal surgery failed to ameliorate visual loss and copious bleeding hindered an appropriate surgical control of the area. 4 Radiation therapy was applied to both patients described, with suboptimal results. Although the lungs and liver represent the most frequent sites of a hematogenous spread of colorectal cancer, clinicians should be able to implement atypical patterns of diffusion in their differential diagnosis and to treat these manifestations accordingly.…”

Simultaneous Nasal Cavity and Brain Metastases from Primary Colon Adenocarcinoma

“…Up to now only seven cases of antral metastases from carcinoma of the gastrointestinal tract have been published, and only four patients with metastases to the paranasal sinus from colonic mucinous adenocarcinoma [1][2][3][4][5][6][7]. Even more rare is the simultaneous metastases to the sinonasal tract with intracranial spread [8].…”