Metastasis of prostatic adenocarcinoma to the sphenoid sinus.
The presentation, diagnosis, and management of prostatic adenocarcinoma metastatic to the sphenoid sinus are reviewed. We present a case report with a review of the literature. A 67-year-old man with a history of prostatic adenocarcinoma presented with gradual left visual loss. Magnetic resonance imaging revealed a lesion of the left orbital apex with extension into the ipsilateral sphenoid sinus. Operative biopsy of the lesion was significant for adenocarcinoma of the prostate. When an otolaryngologist encounters a mass in the sphenoid sinus, he or she needs to consider a diverse differential diagnosis. In evaluating possible causes, a history of malignancies should be elicited. Furthermore, the pathophysiology and potential routes of metastatic disease should be assessed for these primary neoplasms. Having a high level of suspicion for metastatic disease from specific primary sites will help guide the pathological evaluation. As in this clinical scenario of a patient with a history of prostatic adenocarcinoma, appropriate analysis would entail sending specimens for immunohistochemical staining, such as prostate-specific antigen and prostate-specific acid phosphatase. Correct diagnosis is crucial, as these patients may achieve remission and prolonged survival with irradiation and/or hormonal therapy.
Lavasani
Leela
L
Division of Otolaryngology-Head and Neck Surgery, George Washington University Medical Center, Washington, DC, USA.
Zapanta
Philip E
PE
Tanna
Neil
N
Sadeghi
Nader
N
D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010255:Paranasal Sinus Neoplasms / Q000556:secondary* / Q000601:surgery; D011471:Prostatic Neoplasms / Q000473:pathology*; D013101:Sphenoid Sinus / Q000473:pathology* / Q000601:surgery; D014786:Vision Disorders / Q000209:etiology