title: 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.
  
  
  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.
authors.affiliation: Department of Otolaryngology, Queen Alexandra Hospital, Southwick Hill Road, Portsmouth, UK.
authors.forename: James
authors.initials: J
authors.lastname: Johnston
authors.forename: Michael
authors.initials: M
authors.lastname: George
authors.forename: Petros D
authors.initials: PD
authors.lastname: Karkos
authors.forename: Rhagav C
authors.initials: RC
authors.lastname: Dwivedi
authors.forename: Samuel C
authors.initials: SC
authors.lastname: Leong
keywords: breast cancer; ethmoid; metastasis; paranasal sinuses; sphenoid