ABSTRACT
Distant metastasis in advanced breast cancer is not uncommon; however, spread to the paranasal sinuses is extremely rare. We present a case of a woman who presented to our ophthalmology colleagues with worsening unilateral proptosis secondary to a tumour mass within her ethmoid sinuses. Biopsy of the ethmoid tumour showed adenocarcinoma of unknown origin. Whole-body positron emission computed tomography demonstrated a breast primary lesion. The patient was treated with palliative chemotherapy, and the patient remains well at this point. The importance of specialist head and neck radiological interpretation of imaging cannot be underestimated. Early tissue diagnosis is essential before ascribing patients with orbital symptoms to non-malignant process.
Subject(s)
Adenocarcinoma/secondary , Breast Neoplasms/pathology , Ethmoid Sinus , Paranasal Sinus Neoplasms/secondary , Adenocarcinoma/diagnosis , Breast Neoplasms/diagnosis , Female , Humans , Middle Aged , Paranasal Sinus Neoplasms/diagnosisABSTRACT
OBJECTIVE: To establish Australian population-based incidence trends for mucosal melanoma of the head and neck. METHODS: Cases between 1985 and 2009 were identified in the Australian Cancer Database. Age-standardised incidence trends were established, including subgroup stratification by sex and site. RESULTS: A continuously progressive increase in incidence was evident in the 353 cases identified over the 25-year study period. This was particularly evident in sinonasal mucosal melanoma in men, despite the overall incidence remaining higher in women. CONCLUSION: There is such paucity in published global incidence trends of head and neck mucosal melanoma. Comparisons of incidence patterns between countries can provide insight into aetiological factors of this rare disease.
Subject(s)
Head and Neck Neoplasms/epidemiology , Melanoma/epidemiology , Skin Neoplasms/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Australia/epidemiology , Child , Child, Preschool , Female , Humans , Incidence , Infant , Infant, Newborn , Male , Middle Aged , Sex Distribution , Young AdultSubject(s)
Analgesics/administration & dosage , Central Nervous System Stimulants/administration & dosage , Doping in Sports/prevention & control , Drug Prescriptions/statistics & numerical data , Medication Errors/prevention & control , Practice Patterns, Physicians'/statistics & numerical data , Sports , Humans , LondonSubject(s)
Breast Feeding , Clinical Audit , Oral Surgical Procedures/methods , Tongue Diseases/surgery , Tongue/surgery , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Lingual Frenum/abnormalities , Lingual Frenum/surgery , Male , Patient Satisfaction , Prospective Studies , Tongue/abnormalities , Tongue Diseases/congenital , Treatment OutcomeABSTRACT
OBJECTIVE: We present an extremely rare case of a 44-year-old woman with right gustatory otorrhoea and otalgia. CASE REPORT: The patient had been initially treated for otitis externa after Pseudomonas aeruginosa was grown from a microbiological swab. The otorrhoea fluid was collected and tested positive for amylase. Sialography and computed tomography imaging of the temporal bone confirmed a sialo-aural fistula from the right parotid gland to the bony external acoustic meatus. The defect was consistent with a patent foramen of Huschke. The fistula was identified surgically via a superficial parotidectomy approach, after contrast injection of Bonney's blue dye into the parotid duct, and then ligated and divided. The patient had immediate and sustained resolution of her otorrhoea. CONCLUSIONS: Sialo-aural fistulae are extremely rare, and usually arise as a complication of surgery or as an acquired disease process. To date, only four cases have been reported. This case demonstrates the use of sensitive investigation involving sialography and computed tomography, as well as successful surgical management, with complete resolution of symptoms.
