A Rare Case Report of Metastatic Colorectal Cancer to Sphenoid Wing

Document Type

Conference Proceeding

Publication Date

9-2019

Publication Title

Archives of Pathology and Laboratory Medicine

Abstract

Metastatic colorectal cancer to the orbit and paranasal sinuses is rare. There have only been 5 previously published reports describing the involvement of sinonasal tract secondary to metastatic colorectal cancer. We report a case of a 54-year-old woman who was diagnosed with rectal adenocarcinoma in 2017, status post chemoradiation therapy (2017) and surgical resection (2018), with pathologic staging of ypT3ypN2b with acute onset of facial pain and numbness. Patient initially developed numbness of right face (approximately 2 months postsurgery), at which time computed tomography (CT) scan of head was unremarkable. She was reportedly symptom free until approximately 8 months postsurgery when she had pain of right face and jaw. CT scan of sinuses showed soft tissue infiltration (2.25 cm in greatest dimension; Figure 24, A, with arrow) surrounding right pterygoid bone with extension into pterygopalatine fossa, sphenopalatine foramen, and Vidian canal with surrounding demineralization of the sphenoid bone. She underwent right endoscopic sphenoidotomy with biopsy of the mass that was microscopically consistent with moderately differentiated adenocarcinoma with mucin production, with immunohistochemistry consistent with colorectal origin. She underwent radiation therapy to the right skull base without any further reported complications or any other metastatic lesions thus far. The 5 previously published reports present cases with varying signs and symptoms including isolated vision loss, exophthalmos, and as incidental findings with metastatic colon cancer to other organs. To our knowledge this is the first case presentation with symptoms of unilateral facial numbness and pain secondary to metastatic colon cancer to the sphenoid wing.

Volume

143

Issue

9

First Page

e14

Comments

College of American Pathologists Annual Meeting, September 21-25, 2019, Orlando, FL

Last Page

e14

DOI

10.5858/arpa.2019-0901-AB

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