Late metastasis to macroscopically normal paranasal sinuses from breast cancer

Abstract

Background: Breast cancer can very rarely result in late metastases to the paranasal sinuses.

Methods and results: We present a 75-year-old woman who developed sinonasal symptoms mimicking sinusitis 20 years after receiving a breast cancer diagnosis. Rigid nasendoscopy was unremarkable, but due to persistent unilateral nasal symptoms and suspicious radiological findings, the patient underwent endoscopic biopsies of macroscopically normal sinuses which confirmed metastatic breast cancer.

Conclusions: High suspicion index, a thorough history, and examination are of paramount importance as metastases to the sinuses from breast cancer can occur even 20 years after diagnosis.

Keywords: breast cancer; ethmoid; metastasis; paranasal sinuses; sphenoid.

Figure 1:. Whole body nuclear medicine bone scan showing increased uptake in the right ethmoid and maxillary sinuses.

Figure 2:. Coronal CT scan showing non-specific findings of “mucosal disease” involving the right maxillary, ethmoid, and sphenoid sinuses. An erosion of the lateral wall of right sphenoid is also noted.