title: [Metastasis of rectal adenocarcinoma to the skull base and paranasal sinuses, with unusual clinical symptoms].
abstract: BACKGROUND
  The isolated distant metastasis of digestive tract adenocarcinoma, to the head and neck region is very rare. Also, the VI cranial nerve paralysis, present, as an isolated symptom of the disease, in this case is very rare.
  
  
  METHODS
  The diagnosis in 71 years female patient was based on CT, endoscopic examination and biopsy, and pathologic examination, with immunohistochemical differentiation between primary intestinal type adenocarcinoma of paranasal sinuses, and metastasis of adenocarcinoma from digestive tract.
  
  
  RESULTS
  The immunohistochemical staining (CEA +, CK20 +, CK7 -, ChrA -, NSE -) proved the diagnosis. The colonoscopy revealed asymptomatic primary tumor in colon. The palliative Rtg-therapy was not commenced due to deterioration of general condition of patient. The patient died 2 months after diagnosis was established.
  
  
  CONCLUSIONS
  The importance of differential diagnosis between the primary intestinal type adenocarcinoma in the upper respiratory tract and metastases of adenocarcinoma from digestive tract to head and neck region is crucial, due to entirely different type of treatment planning in both situations.
authors.affiliation: Dział Otolaryngologii Chirurgii Głowy i Szyi, Swietokrzyskiego Centrum Onkologii w Kielcach.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Bień
authors.forename: Bartłomiej
authors.initials: B
authors.lastname: Kamiński
authors.forename: Sławomir
authors.initials: S
authors.lastname: Okła
authors.forename: Janusz
authors.initials: J
authors.lastname: Kopczyński
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D010255:Paranasal Sinus Neoplasms / Q000556:secondary* / Q000601:surgery; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery; D019292:Skull Base Neoplasms / Q000556:secondary* / Q000601:surgery