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Publication
Metástases temporais: a propósito de um caso clínico
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Advisor(s)
Abstract(s)
A metastização óssea para a cabeça e pescoço é rara. Em
20-35% dos casos, pode ser a primeira manifestação de uma
neoplasia oculta. No caso específico do osso temporal, as
metástases são originárias, mais frequentemente, da mama,
pulmão, rim, próstata e estômago.
Apresenta-se o caso clínico de uma doente, do sexo feminino,
71 anos, com Diagnóstico de Carcinoma Ductal tipo Cribiforme
na mama esquerda, tendo sido submetida a mastectomia
total, quimioterapia e radioterapia.
À observação apresentava um quadro clínico de otalgia
esquerda, associada a paralisia facial da hemiface ipsilateral,
sem outros sintomas otológicos. Foi-lhe diagnosticada Otite
Média Crónica agudizada, tendo sido medicada e pedida
Tomografia Computorizada ao Ouvido Esquerdo, que
demonstrou exuberante espessamento dos tecidos moles
epicranianos temporo-parieto-occipitais à esquerda com
extensão ao canal auditivo externo do mesmo lado. Por
agravamento da sintomatologia, foi internada no Serviço
de Otorrinolaringologia deste hospital para administração
de terapêutica endovenosa, tendo-se admitido a hipótese
diagnóstica de Otite Externa Maligna.
Por manutenção do quadro, apesar de terapêutica optimizada,
foi submetida a intervenção cirúrgica onde foi efectuada
biopsia temporal, tendo sido diagnosticado lesão metastática
por carcinoma invasivo da mama.
The bone metastasis to the head and neck is rare. In 20-35% of cases, can be the first manifestation of an occult neoplasia. In the specific case of the Temporal Bone, metastases originate most often from the breast, lung, kidney, prostate and stomach. We report the case of a patient, female, 71 years, with the diagnosis of Ductal Carcinoma Cribiform type in the left breast, having undergone total mastectomy, chemotherapy and radiotherapy. She presented with left otalgia and ipsilateral hemifacial palsy, without other otologic symptoms. It was diagnosed Complicated Chronic Otitis Media, she was medicated and Computed Tomography ordered, wich demonstrated an exuberant thickening of the epicranial soft parts with extension to the ispilateral external auditory channel. For worsening symptoms, the patient was admitted to the Otorhinolaryngology Service of this hospital for administration of intravenous treatment, and it was hypothesized the diagnosis of malignant external otitis. For maintenance of the frame, despite optimal therapy, she was subjected to surgical intervention and performed temporal biopsy that diagnosed metastatic lesions of invasive breast carcinoma.
The bone metastasis to the head and neck is rare. In 20-35% of cases, can be the first manifestation of an occult neoplasia. In the specific case of the Temporal Bone, metastases originate most often from the breast, lung, kidney, prostate and stomach. We report the case of a patient, female, 71 years, with the diagnosis of Ductal Carcinoma Cribiform type in the left breast, having undergone total mastectomy, chemotherapy and radiotherapy. She presented with left otalgia and ipsilateral hemifacial palsy, without other otologic symptoms. It was diagnosed Complicated Chronic Otitis Media, she was medicated and Computed Tomography ordered, wich demonstrated an exuberant thickening of the epicranial soft parts with extension to the ispilateral external auditory channel. For worsening symptoms, the patient was admitted to the Otorhinolaryngology Service of this hospital for administration of intravenous treatment, and it was hypothesized the diagnosis of malignant external otitis. For maintenance of the frame, despite optimal therapy, she was subjected to surgical intervention and performed temporal biopsy that diagnosed metastatic lesions of invasive breast carcinoma.
Description
Keywords
Neoplasias dos ossos Osso temporal Metástases
Citation
Rev Port Otorrinol Cirur Cerv Fac. 2014 Mar,52(2)103-105
Publisher
Sociedade Portuguesa de Otorrinolaringologia e Cirurgia Cérvico-Facial