title: An unusual case of metastatic male breast cancer to the nasopharynx-review of literature.
abstract: Metastatic breast carcinoma has been described to the various areas in the head and neck region. However, these metastases are rarely found in nasopharynx. Herein we are presenting the first case of male breast carcinoma with the longest survival secondary to distant metastases in right maxillary sinus and extending to the nasopharynx with extensive skeletal & lung metastases. Here we present a case of 65-year-old male with past medical history of right breast carcinoma, presented clinically with symptoms of recurrent sinusitis. Physical examination revealed a mass in the nasopharynx, which subsequently proved to be hormonal receptor positive high-grade adenocarcinoma secondary to metastasis of primary breast cancer on biopsy. The patient received three cycles of palliative chemotherapy based on Doxorubicin with Paclitaxel weekly. In spite of that, he developed pulmonary, liver and bone metastases. Later, treatment regimen was changed to Gemcitabine, Paclitaxel and injectable Zolendronate with calcium and vitamin D supplementation. Still he didn't show any improvement and later, he developed febrile neutropenia. Then, he refused further chemotherapy and died after 12 months of receiving the best hospice care. Breast cancer is one of the most common cancers in terms of incidence and mortality; breast cancer deserves extensive studies and research in different aspects. Breast cancer metastasizing to nasopharynx would be the last diagnosis that comes to mind for a male patient presenting with clinical features suggestive of recurrent sinusitis infection. As recurrent sinusitis is a very common ailment affecting human kind and is mostly due to benign causes. Metastasis, although rare, should be included in the differential diagnosis of nasopharyngeal lesion since it may clinically mimic a benign neoplasm or primary carcinoma. Based on our clinical experience and review of literature, although it is a very rare possibility in a patient with sinusitis, still we advise not to overlook any symptoms suggestive of the etiology of recurrent sinusitis.
authors.affiliation: Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Level 3, Women's Centre, John Radcliffe Hospital, Oxford, UK.
authors.forename: Swati
authors.initials: S
authors.lastname: Agrawal
authors.affiliation: Department of Surgery, Sudha Hospital & Medical Research Center, Kota, Rajasthan 324005, India. jayantsun@yahoo.co.in.
authors.forename: Kumar
authors.initials: K
authors.lastname: Jayant
authors.affiliation: Department of Surgery, Sudha Hospital & Medical Research Center, Kota, Rajasthan 324005, India.
authors.forename: Rajendra Kumar
authors.initials: RK
authors.lastname: Agarwal
authors.affiliation: Medical Superintendent, Department of Surgery, Sudha Hospital & Medical Research Center, Kota, Rajasthan 324005, India.
authors.forename: Kalyan G
authors.initials: KG
authors.lastname: Dayama
authors.affiliation: Department of Obgyn, Sudha Hospital & Medical Research Center, Kota, Rajasthan 324005, India.
authors.forename: Seema
authors.initials: S
authors.lastname: Arora
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology* / Q000556:secondary*; D000368:Aged; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D018567:Breast Neoplasms, Male / Q000473:pathology*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000556:secondary*; D012852:Sinusitis / Q000175:diagnosis
keywords: Breast carcinoma; metastasis; nasopharynx