Metastatic Prostate Carcinoma Masquerading as Primary Sphenoid Sinus Tumour: A Case Report
Metastasis from prostate adenocarcinoma to Paranasal Sinuses (PNS) is extremely rare. Usually, they metastasise to the pelvic lymph nodes and bones of the axial skeleton. Authors hereby, present a case of a 71-year-old male patient with diplopia on left lateral gaze and frontal headache since two mo...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2023-03-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://www.jcdr.net/articles/PDF/17688/61626_CE[Ra1]_F[SK]_PF1(PS_KM)_PN(KM).pdf |
| _version_ | 1797850850872262656 |
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| author | Lincy Joseph Jassal Mathew KP Nabeela |
| author_facet | Lincy Joseph Jassal Mathew KP Nabeela |
| author_sort | Lincy Joseph |
| collection | DOAJ |
| description | Metastasis from prostate adenocarcinoma to Paranasal Sinuses (PNS) is extremely rare. Usually, they metastasise to the pelvic lymph nodes and bones of the axial skeleton. Authors hereby, present a case of a 71-year-old male patient with diplopia on left lateral gaze and frontal headache since two months. On examination, he had left lateral rectus palsy. Computed Tomography (CT) Brain was normal. CT PNS and Magnetic Resonance Imaging (MRI) brain revealed an ill-defined isodense lesion causing clival erosion and extending anteriorly to the sphenoid sinus. The patient underwent endoscopic endonasal trans-sphenoidal excision. The histopathological diagnosis was adenocarcinoma. Immunohistochemistry (IHC) was done for further evaluation which showed both CK7 and CK20 to be negative. Hence, sinonasal carcinoma was excluded and possibility of metastatic tumour was considered. Ultrasonography (USG) abdomen was normal and further IHC showed Prostate-Specific Antigen (PSA) positivity. Elevated serum PSA and Positron Emission Tomography (PET) scan confirmed primary carcinoma prostate with multiple skeletal metastases. The patient was treated with a Gonadotropin-Releasing Hormone (GnRH) antagonist and an antiandrogen which showed good response. So, the possibility of metastasis from an occult primary prostate carcinoma was considered as the differential diagnosis in an elderly patient presenting with sinonasal mass. Hence, proper screening and IHC studies are mandatory for accurate diagnosis and treatment. |
| first_indexed | 2024-04-09T19:08:13Z |
| format | Article |
| id | doaj.art-9194ad08c7c643d991d7432414358e58 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-09T19:08:13Z |
| publishDate | 2023-03-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-9194ad08c7c643d991d7432414358e582023-04-07T08:44:44ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2023-03-01173ED07ED0910.7860/JCDR/2023/61626.17688Metastatic Prostate Carcinoma Masquerading as Primary Sphenoid Sinus Tumour: A Case ReportLincy Joseph0Jassal Mathew1KP Nabeela2Professor and Head, Department of Pathology, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India.Third Year MBBS Student, Department of NIL, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India.Junior Resident, Department of Pathology, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India.Metastasis from prostate adenocarcinoma to Paranasal Sinuses (PNS) is extremely rare. Usually, they metastasise to the pelvic lymph nodes and bones of the axial skeleton. Authors hereby, present a case of a 71-year-old male patient with diplopia on left lateral gaze and frontal headache since two months. On examination, he had left lateral rectus palsy. Computed Tomography (CT) Brain was normal. CT PNS and Magnetic Resonance Imaging (MRI) brain revealed an ill-defined isodense lesion causing clival erosion and extending anteriorly to the sphenoid sinus. The patient underwent endoscopic endonasal trans-sphenoidal excision. The histopathological diagnosis was adenocarcinoma. Immunohistochemistry (IHC) was done for further evaluation which showed both CK7 and CK20 to be negative. Hence, sinonasal carcinoma was excluded and possibility of metastatic tumour was considered. Ultrasonography (USG) abdomen was normal and further IHC showed Prostate-Specific Antigen (PSA) positivity. Elevated serum PSA and Positron Emission Tomography (PET) scan confirmed primary carcinoma prostate with multiple skeletal metastases. The patient was treated with a Gonadotropin-Releasing Hormone (GnRH) antagonist and an antiandrogen which showed good response. So, the possibility of metastasis from an occult primary prostate carcinoma was considered as the differential diagnosis in an elderly patient presenting with sinonasal mass. Hence, proper screening and IHC studies are mandatory for accurate diagnosis and treatment.https://www.jcdr.net/articles/PDF/17688/61626_CE[Ra1]_F[SK]_PF1(PS_KM)_PN(KM).pdfadenocarcinomadiplopiaimmunohistochemistryparanasal |
| spellingShingle | Lincy Joseph Jassal Mathew KP Nabeela Metastatic Prostate Carcinoma Masquerading as Primary Sphenoid Sinus Tumour: A Case Report Journal of Clinical and Diagnostic Research adenocarcinoma diplopia immunohistochemistry paranasal |
| title | Metastatic Prostate Carcinoma Masquerading as Primary Sphenoid Sinus Tumour: A Case Report |
| title_full | Metastatic Prostate Carcinoma Masquerading as Primary Sphenoid Sinus Tumour: A Case Report |
| title_fullStr | Metastatic Prostate Carcinoma Masquerading as Primary Sphenoid Sinus Tumour: A Case Report |
| title_full_unstemmed | Metastatic Prostate Carcinoma Masquerading as Primary Sphenoid Sinus Tumour: A Case Report |
| title_short | Metastatic Prostate Carcinoma Masquerading as Primary Sphenoid Sinus Tumour: A Case Report |
| title_sort | metastatic prostate carcinoma masquerading as primary sphenoid sinus tumour a case report |
| topic | adenocarcinoma diplopia immunohistochemistry paranasal |
| url | https://www.jcdr.net/articles/PDF/17688/61626_CE[Ra1]_F[SK]_PF1(PS_KM)_PN(KM).pdf |
| work_keys_str_mv | AT lincyjoseph metastaticprostatecarcinomamasqueradingasprimarysphenoidsinustumouracasereport AT jassalmathew metastaticprostatecarcinomamasqueradingasprimarysphenoidsinustumouracasereport AT kpnabeela metastaticprostatecarcinomamasqueradingasprimarysphenoidsinustumouracasereport |