Abstract
Approximately 4% of the patients present with distant metastasis in breast cancer at the time of presentation, with many more
developing the distant disease subsequently. A rare site for metastases is the head and neck. Herein, we present a case of nasal septum metastasis
from breast cancer. A female patient presented with a mass in the right breast with the diagnosis of breast cancer. She presented with bilateral
pulmonary and bony lesions, after 2 years of follow-up. Vinorelbine therapy was continued, and the patient presented with refractory
epistaxis. On physical examination, a reddish and fragile mass in the left nasal cavity was detected. Bleeding was controlled using compressive
measures. The excisional biopsy revealed invasive ductal carcinoma metastasis. Breast cancer metastasis to the nasal cavity is extremely
rare. Clinicians should consider metastasis in cases of treatment-resistant epistaxis, nasal obstruction, and visual impairment.
Keywords:
Breast neoplasms, neoplasm metastasis, nasal septum
References
1Diaby V, Tawk R, Sanogo V, Xiao H, Montero AJ. A review of systematic reviews of the cost-effectiveness of hormone therapy, chemotherapy, and targeted therapy for breast cancer. Breast Cancer Res Treat. 2015;151(1):27-40.
2Dietl B, Marienhagen J, Schaefer C, Pohl F, Kölbl O. [Frequency and distribution pattern of distant metastases in patients with ENT tumors and their consequences for pretherapeutic staging]. Strahlenther Onkol. 2007;183(3):138-143.
3Tracy JC, Mildenhall NR, Wein RO, O'Leary MA. Breast cancer metastases to the head and neck: case series and literature review. Ear Nose Throat J. 2017;96(3):E21-E24.
4Allen A, Michals E, Karo A, Loeffler DM, Saran N. Renal cell carcinoma presenting as epistaxis from a nasal cavity metastasis. Radiol Case Rep. 2018;14(1):116-120.
5Bastier PL, Dunion D, de Bonnecaze G, Serrano E, de Gabory L. Renal cell carcinoma metastatic to the sinonasal cavity: a review and report of 8 cases. Ear Nose Throat J. 2018;97(9):E6-E12.
6Prescher A, Brors D. [Metastases to the paranasal sinuses: case report and review of the literature]. Laryngorhinootologie. 2001;80(10):583-594.
7Agrawal S, Jayant K. Breast cancer with metastasis to the nasopharynx and paranasal sinuses. Breast J. 2016;22(4):476-477.
8Copson B, Pratap U, McLean C, Hayes T. Nasopharyngeal metastasis of breast carcinoma with HER 2 discordance: a case report. ANZ J Surg. 2018;88(5):508-509.
9Weng B, Wang Q, Lin S, Lu Y. Nasal cavity metastasis of breast cancer: a case report and review of the literature. Int J Clin Exp Pathol. 2014;7(10):7028-7033.
10Vega LG, Dipasquale J, Gutta R. Head and neck manifestations of distant carcinomas. Oral Maxillofac Surg Clin North Am. 2008;20(4):609-623.
11Liao HS, Hsueh C, Chen SC, Chen IH, Liao CT, Huang SF. Solitary nasal cavity metastasis of breast cancer. Breast J. 2010;16(3):321-322.
12Özgür E. ÜH, Jurlina M. Endoscopic management of malignant sinonasal tumours. In: Cingi C, Bayar Muluk N, eds. All Around the Nose Basic Science, Diseases and Surgical Management. 1st ed. Cham: Springer; 2020. p.635-41.
13Luong A, Citardi MJ, Batra PS. Management of sinonasal malignant neoplasms: defining the role of endoscopy. Am J Rhinol Allergy. 2010;24(2):150-5.
