Metastases of a Breast Cancer to Skull Base

Download PDF Česká verzia

Authors: Horakova Zuzana ¹; Slavik Marek ²; Vesely Karel ³; Binkova Hana ¹; Smilek Pavel ¹
Authors place of work: Department of otorhinolaryngology head and neck surgery, Faculty of Medicine, Masaryk University, St. Anne’s University Hospital, Brno, Czech Republic ¹; Clinic of radiation oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic ²; Department of pathology, Faculty of Medicine, Masaryk University, St. Anne’s University Hospital, Brno, Czech Republic ³
Published in the journal: Klin Onkol 2018; 31(4): 293-295
Category: Case Report
doi: https://doi.org/10.14735/amko2018293

Summary

Background:

Breast cancer (BC) is a frequent malignant disease which tends to develop distant metastases, but only very rarely in the head and neck region.

Case report:

We present two case reports of patients with metastases of invasive BC in this area. They are of different clinical manifestation with different time relation to the primary tumor and different symptomatology. In the case of the first patient, a few years without evidence of malignant disease after treatment of primary tumor in complete remission. In the case of the second patient, as the first symptom of undiagnosed disease. Metastases were clinically observed in the skull base and maxillary sinus, manifesting neurologically with foramen jugulare syndrome and orbital symptoms, resp. In both cases, correlations between histological and clinical findings were essential for diagnosis. Palliative multimodal treatment was then employed.

Conclusion:

Metastases of BC in the head and neck region occur only very rarely. The extremely variable symptomatology depends on the location of the metastasis and the affected structures. This might be a pitfall for diagnostics, especially in cases of an unidentified primary breast tumor, which may result in a delay of correct diagnosis. In addition, the correlation between histopathological and clinical findings might be of great relevance in these cases.

Key words:

skull base metastasis – breast cancer – foramen jugulare syndrome

Zdroje

1. Raap M, Antonopoulus W, Dammrich M et al. High frequency of lobular breast cancer in distant metastasese to the orbit. Cancer Med 2015; 4 (1): 104–111. doi: 10.1002/cam4.331.

2. Schneider C, Fehr MK, Steiner RA et al. Frequency and distribution pattern of distant metastases in breast cancer patients at the time of primary presentation. Arch Gynecol Obstet 2003; 269: 9–12. doi: 10.1007/s00404-002-0445-x.

3. Garcia TD, Molina QC, Sanz FR. Ethmoid metastasis of primary breast tumour. Acta Otorrinolaringol Esp 1998; 49 (2): 163–164.

4. Pignataro L, Peri A, Ottaviani F. Breast carcinoma metastatic to the ethmoid sinus: a case report. Tumori 2001; 87 (6): 455–457.

5. Flis DW, Shah AT, Tracy JC et al. Metastatic breast carcinoma of the jugular foramen: a rare case of Billaret syndrome. Head Neck 2015; 37 (11): 146–149. doi: 10.1002/hed.24008.

6. Löwenheim H, Koerbel A, Ebner FH et al. Differentiating imaging findings in primary and secondary tumors of the jugular foramen. Neurosurg Rev 2006; 29 (1): 1–11. doi: 10.1007/s10143-005-0420-7.

7. Wanamaker JR, Kraus DH, Eliachar I et al. Manifestations of metastatic breast carcinoma to the head and neck. Head Neck 1993; 15 (3): 257–262.