Paraliza facijalnog nerva kao prvi znak kasne metastaze karcinoma dojke u temporalnu kost

  • Zoran Dudvarski University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Nenad Arsović University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Milovan Dimitrijević University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Saša Jakovljević University Clinical Center of Serbia, Clinic of Otorhinolaryngology and Maxillofacial Surgery, Belgrade, Serbia
  • Novica Boričić University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Ivan Boričić University of Belgrade, Faculty of Medicine, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP210212040D
Ključne reči: dojka, neoplazme, facijalni nerv, bolesti, imunohistohemija, neoplazme, metastaze, temporalna kost, tomografija, kompjuterizovana, rendgenska, lečenje, ishod

Sažetak


Uvod. Kasne metastaze malignih tumora u temporalnoj kosti su veoma retke lezije. One dugo mogu biti asimptomatske i obično se manifestuju gubitkom sluha, vrtoglavicom, zujanjem u ušima i paralizom facijalnog nerva. Savremena radiološka dijagnostika i eksplorativna hirurgija sa biopsijom neophodni su za dijagnozu. Prikaz bolesnika. Prikazujemo redak i neobičan slučaj 66-godišnje bolesnice sa paralizom facijalnog nerva koja se pojavila kao prvi znak metastatskog karcinoma dojke u temporalnoj kosti 10 godina nakon lečenja. Nagli gubitak sluha i vrtoglavica pojavili su se šest meseci kasnije, a vrednost CA 15-3 bila je povišena. Scintigrafija je ukazala na moguće metastatske depozite osovinskog skeleta, bez lezija u temporalnoj kosti. Konačno, ponovljena kompjuterizovana tomografija otkrila je osteolitičke promene temporalne kosti, šest meseci nakon toga. Imunohistohemijska analiza uzoraka tkiva iz mastoida potvrdila je da se radilo o metastazi karcinoma dojke. Godinu dana nakon palijativne radioterapije i oralne hormonske terapije, bolesnica je bila dobrog opšteg stanja, sa boljom funkcijom facijalnog nerva. Zaključak. Visok stepen kliničke sumnje ponekad zahteva ponavljanu radiološku dijagnostiku kako bi se otkrile osteolitičke metastatske promene u temporalnoj kosti, ali i na ostalim koštanim strukturama, u okviru hematogene diseminacije maligne bolesti.  

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Objavljeno
2022/09/21
Broj časopisa
Vol. 79 Br. 7 (2022): Vojnosanitetski pregled
Rubrika
Prikaz bolesnika