Cavernous sinus syndrome associated with metastatic colorectal cancer and perineural spread along the trigeminal nerve (original) (raw)
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Metastatic involvement of the Meckel's cave and trigeminal nerve. A case report
Journal of neuro-oncology, 1997
The case of a patient with a right atypical trigeminal neuralgia caused by a metastatic tumor involving the Meckel's cave is reported. His medical history was significant for colon-rectal adenocarcinoma. The preoperative diagnosis of Meckel's cave neoplasm was made by MR. The patient underwent surgery, consisting of total removal of tumor and peeling of the ganglion and of the branches of the nerve, obtaining a histological diagnosis and a resolution of pain. The clinical, radiological findings and the treatment of this rare entity are discussed.
A Rare Case of Metastases to Paranasal Sinus From Colonic Adenocarcinoma
Cureus, 2021
Metastases of malignant tumors to the nasal cavity and paranasal sinuses are very rare. Metastases to these locations are usually solitary and produce similar symptoms to those of a primary sinonasal tumor. Pain, nasal obstruction, and epistaxis are the most common symptoms. Although any malignancy could potentially lead to metastasis to the paranasal sinuses, colo-rectal malignancy metastasizes to this site is rare. We report a case of metastatic adenocarcinoma of colorectal origin to the paranasal sinuses in a 55-year-old female who was initially diagnosed with adenocarcinoma of the colon with lung and liver metastasis. She subsequently developed metastasis to left ethmoidal and sphenoidal sinuses during treatment. A histologic study of the surgical specimen from the sinonasal cavity demonstrated a tumor identical to the patient's prior primary tumor of the colon. The sinonasal neoplastic tissue showed marked positivity for carcinoembryonic antigen and expressed cytokeratin 20, which differentiates metastatic colonic adenocarcinoma from primary intestinal-type adenocarcinoma (ITAC). She received palliative radiation therapy but died three months after the diagnosis. These subsets of patients have a poor prognosis. In the majority of patients, palliative therapy is the only possible treatment option. Nevertheless, whenever possible, surgical excision either alone or combined with radiotherapy may be useful for palliation of symptoms and, rarely, to achieve prolonged survival.
Oral Surgery, 2020
Metastases account for only 0.8% of all tonsillar malignancies and the lung, breast, kidney and melanoma are the commonest primary sites. Metastasis of colorectal carcinoma to the palatine tonsil is rare. We report of a 73-year-old man who presented with metastatic colorectal carcinoma in the right tonsil as the first presentation; the primary colorectal adenocarcinoma was diagnosed retrospectively. On magnetic resonance imaging, a 3.45cm tumour was identified in the right oropharynx with associated lymphadenopathy. Tonsillectomy histology confirmed metastatic colorectal adenocarcinoma. On further imaging, an 8cm mass was identified in the sigmoid colon and a biopsy confirmed a poorly differentiated adenocarcinoma. The patient received 2 cycles of palliative chemotherapy but died 5 months following presentation. Literature review identified thirteen case reports in the English scientific literature and clinicopathological analysis of these is presented. The mean age was 55.21 years (age range-37 to 81) with male predominance. Half of the patients had a primary tumour in the rectum. Tonsillar involvement was either primary presentation or has been present at the time of diagnosis of primary colorectal tumour in five cases; in all of these, the differentiation of tumour was poor and 3/5 had signet ring morphology. These tumours showed poor prognosis and the life expectancy was 6 to 15 months irrespective of the type of treatment. This case highlights the importance of considering metastatic carcinoma in the differential diagnosis even at unlikely sites.
Metastasis to the parotid gland from colorectal adenocarcinoma
Diseases of the Colon & Rectum, 1985
This manuscript presents only the fifth reported case in the literature of colorectal carcinoma with metastasis to the parotid gland. A 66-yearold white woman, referred to Roswell Park Memorial Institute, presented with a left parotid mass and a past history of undergoing right hemicolectomy for an adenocarcinoma of the ascending colon with synchronous liver metastases. The clinical presentation and treatment of the patient are discussed with a review of the literature. [Key words: Colorectal; Adenocarcinoma; Parotidl METASTASES FROM COLORECTAL CARCINOMA have been found in almost all body sites. Most of the literature reviews have been from autopsy series. 1-3 In searching the literature, we were able to document only four reported cases of colorectal carcinoma with metastasis to the parotid gland. 4-7 In three of these patients, the diagnosis was made preoperatively. 5, 6 Because of the rarity of this presentation, therapeutic guidelines are not well-defined in the surgical literature. This discussion presents the fifth case report of metastasis to the parotid gland from colorectal adenocarcinoma. Report of a Case A 66-year-old white woman was referred to Roswell Park Memorial Institute (RPMI) with a previous three-month history of right upper quadrant pain and generalized malaise. Symptoms were attributed to a right subcostal incisional hernia. Two months prior to admission to RPMI, during surgical repair of the right subcostal incisional hernia, multiple liver nodules were found that were consistent with metastatic adenocarcinoma. Further evaluation revealed an ascending colon car
Adenoid Cystic Carcinoma Presenting as Abducens Nerve Palsy Secondary to Cavernous Sinus Lesion
Annals of Neurosciences, 2017
A 61-year-old female was referred to our hospital following a 3-week history of headaches and diplopia. She had no significant past medical history and was a nonsmoker. Examination revealed right abducens nerve palsy. Neurological examination was otherwise unremarkable. Initial investigation with a contrast-enhanced CT revealed a homogenously enhancing extra-axial mass in the medial aspect of the right middle cranial fossa involving the lateral wall of the cavernous sinus. There was no adjacent bone destruction or osteoslcerosis. Contrast-enhanced MRI demonstrated the homogenously enhancing right middle cranial fossa mass filling the right cavernous sinus and extending medially into the pituitary fossa, as well as encasing the internal carotid artery (ICA). There was compression of the mesial temporal lobe and edema. A small extracranial component of the mass was noted, with extension through foramen ova
A rare case of metastatic colon cancer to the pineal region: A case report
Surgical Neurology International
Background: Colorectal cancer is the third most common cancer and the third most leading cause of death in the United States with brain being a rare site for metastasis and the pineal region being a rarer site to manifest. Case Description: We present a rare case of a 72-year-old male patient with pineal region tumor and obstructive hydrocephalus for which an endoscopic third ventriculostomy was done with biopsy of the tumor showing primary colorectal origin in a patient known to be previously healthy. Conclusion: Intracranial metastasis to the pineal region is considered rare especially in cases without widely spread systematic cancer or without presence of other metastatic lesions in the brain. The case we presented suggests that we should consider pineal region metastasis as part of our differential whenever we encounter patients with an isolated pineal lesion. Endoscopic third ventriculostomy can be a better treatment option to treat obstructive hydrocephalus caused by the lesio...
ecancermedicalscience, 2016
Introduction: Involvement of the central nervous system (CNS) secondary to colorectal cancer is infrequent and associated with a poor prognosis. Its treatment is extrapolated from metastases of other origins as the information available on this scenario is limited. The goal of this study is to assess the clinical characteristics of a series of patients and determine the results in terms of progression-free survival (PFS) and global survival. Method: The records of patients with CNS metastasis of colorectal origin who were treated in this facility between the years 2001 and 2016 were reviewed retrospectively. Results: 20 patients with CNS lesions of this origin were identified. Of these, 45% were male and 55% were female (average age 65.5 years). The histology corresponded to tubular adenocarcinoma in 95% of cases. Around 85% of the patients showed a neurological deficit, and their recursive partitioning analysis (RPA) classifications were 1 in 20%, 2 in 55%, and 3 in 25% of the cases studied. The treatments provided were: holocerebral radiotherapy (45%), stereotactic radiosurgery (25%), surgery followed by holocerebral radiotherapy (25%), and exclusively palliative care (5%). The PFS was 2.6 months from treatment of the CNS lesion, while the median survival was 3.8 months. The survival times for patients receiving different treatments were as follows: surgery plus holocerebral radiotherapy 16.2 months, stereotactic radiotherapy 12 months, and holocerebral radiotherapy 2.4 months (p = 0.003). Conclusion: The prognosis for patients with metastasis of colorectal origin is poor. The patients treated with surgery or stereotactic radiotherapy can have a greater survival.