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array:23 [ "pii" => "S2173579424001725" "issn" => "21735794" "doi" => "10.1016/j.oftale.2024.10.007" "estado" => "S100" "fechaPublicacion" => "2024-10-21" "aid" => "2290" "copyright" => "Sociedad Española de Oftalmología" "copyrightAnyo" => "2024" "documento" => "article" "crossmark" => 0 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:18 [ "pii" => "S0365669124001667" "issn" => "03656691" "doi" => "10.1016/j.oftal.2024.08.005" "estado" => "S200" "fechaPublicacion" => "2024-08-23" "aid" => "2290" "copyright" => "Sociedad Española de Oftalmología" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Comunicación corta</span>" "titulo" => "Metástasis no osteoblástica rinosinusal y orbitaria por adenocarcinoma de próstata" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Non-osteoblastic rhinosinusal and orbital metastasis due to prostate adenocarcinoma" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 705 "Ancho" => 2458 "Tamanyo" => 173344 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">TC de órbitas con contraste endovenoso. Izquierda: engrosamiento de la porción proximal de los músculos extraoculares, a predominio del recto lateral y realce poscontraste endovenoso (punta de flecha). Centro: aumento de tamaño del seno cavernoso derecho (flecha) y compromiso del seno esfenoidal. Derecha: en la ventana ósea muestra la destrucción ósea de los tabiques de celdillas etmoidales y paredes del seno maxilar.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "N.C. Pereyra, L.G. Otonelli, M.A. Arriaga, L.L. Iacono, M.L. Braccia Gancedo, L. Sarotto" "autores" => array:6 [ 0 => array:2 [ "nombre" => "N.C." "apellidos" => "Pereyra" ] 1 => array:2 [ "nombre" => "L.G." "apellidos" => "Otonelli" ] 2 => array:2 [ "nombre" => "M.A." "apellidos" => "Arriaga" ] 3 => array:2 [ "nombre" => "L.L." "apellidos" => "Iacono" ] 4 => array:2 [ "nombre" => "M.L." "apellidos" => "Braccia Gancedo" ] 5 => array:2 [ "nombre" => "L." "apellidos" => "Sarotto" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173579424001725" "doi" => "10.1016/j.oftale.2024.10.007" "estado" => "S100" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579424001725?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669124001667?idApp=UINPBA00004N" "url" => "/03656691/unassign/S0365669124001667/v2_202410180444/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2173579424001671" "issn" => "21735794" "doi" => "10.1016/j.oftale.2024.10.002" "estado" => "S100" "fechaPublicacion" => "2024-10-21" "aid" => "2280" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 0 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Recurrent VI cranial nerve paralysis secondary to idiopathic cavernous sinus pachymeningitis: a case report" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Parálisis recurrente de VI nervio craneal secundaria a paquimeningitis idiopática del seno cavernoso: comunicación de un caso" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 795 "Ancho" => 1500 "Tamanyo" => 90039 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Axial and coronal images (left and right, respectively) enhanced in T1 after IV contrast administration from 2021, showing stability of the findings vs the 2011 diagnostic study.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L. Picasso Simón, M. Castro-Rebollo, B. Sastre Borregón, J. González-Martín-Moro" "autores" => array:4 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Picasso Simón" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Castro-Rebollo" ] 2 => array:2 [ "nombre" => "B." "apellidos" => "Sastre Borregón" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "González-Martín-Moro" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669124001291" "doi" => "10.1016/j.oftal.2024.07.005" "estado" => "S200" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669124001291?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579424001671?idApp=UINPBA00004N" "url" => "/21735794/unassign/S2173579424001671/v1_202410210435/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S217357942030219X" "issn" => "21735794" "doi" => "10.1016/j.oftale.2020.07.009" "estado" => "S200" "fechaPublicacion" => "2020-11-15" "aid" => "1791" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 0 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Multimodal imaging in acute idiopathic blind spot enlargement syndrome" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Imagen multimodal en el síndrome de aumento idiopático de mancha ciega" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 722 "Ancho" => 1505 "Tamanyo" => 297842 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">At debut, OCT-DE of the first case showed (A) a subfoveal column hyperreflectivity and focal loss of the outer limiting membrane and ellipsoid line at the nasal level (red arrow). The choroidal thinning (white arrow) at nasal level could be physiological and attributable to the patient’s myopia. Subfoveal hyperreflectivity resolved at two weeks (B) leaving a minimal sequel of subfoveal RPE thickening at 1.5 months (C). The outer nasal layers progressively recovered (B and C). In A-OCT 8<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>8 <span class="elsevierStyleItalic">en-face,</span> at ellipsoid layer level, hyperreflective points were observed surrounding the papilla (green arrow) at debut (D). After two weeks (E), these peripapillary hyperreflective points decreased but hyporeflective spots were observed (white arrow), which correlate with the disruption of the outer retina in autofluorescence. After 1.5 months (F), hyporeflective spots decreased and white peripapillary spots disappeared. The A-OCT 3<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3 showed at choriocapillary level two apparent hypoperfusion spots in the debut of the disease (G), which correlate with the shadow of the subfoveal column hyperreflectivity.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Moll-Udina, I. Hernanz, M. Dotti, V. Llorenç, A. Adán" "autores" => array:5 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Moll-Udina" ] 1 => array:2 [ "nombre" => "I." "apellidos" => "Hernanz" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Dotti" ] 3 => array:2 [ "nombre" => "V." "apellidos" => "Llorenç" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Adán" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669120303105" "doi" => "10.1016/j.oftal.2020.07.014" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669120303105?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357942030219X?idApp=UINPBA00004N" "url" => "/21735794/unassign/S217357942030219X/v1_202011150602/en/main.assets" ] "en" => array:18 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Non-osteoblastic rhinosinusal and orbital metastasis due to prostate adenocarcinoma" "tieneTextoCompleto" => true "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "N.C. Pereyra, L.G. Otonelli, M.A. Arriaga, L.L. Iacono, M.L. Braccia Gancedo, L. Sarotto" "autores" => array:6 [ 0 => array:4 [ "nombre" => "N.C." "apellidos" => "Pereyra" "email" => array:1 [ 0 => "caro.pereyra96@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:4 [ "nombre" => "L.G." "apellidos" => "Otonelli" "email" => array:1 [ 0 => "luciano.otonelli@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:4 [ "nombre" => "M.A." "apellidos" => "Arriaga" "email" => array:1 [ 0 => "arraigamariaalejandra@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:4 [ "nombre" => "L.L." "apellidos" => "Iacono" "email" => array:1 [ 0 => "lucianaliacono@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:4 [ "nombre" => "M.L." "apellidos" => "Braccia Gancedo" "email" => array:1 [ 0 => "laurabraccia@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:4 [ "nombre" => "L." "apellidos" => "Sarotto" "email" => array:1 [ 0 => "lidiasarotto@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Hospital de Clínicas “José de San Martin”, Division de Oftalmología, Universidad de Buenos Aires, Facultad de Medicina, Buenos Aires, Argentina" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hospital Británico de Buenos Aires, Departamento de Diagnóstico por Imágenes, Buenos Aires, Argentina" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Metástasis no osteoblástica rinosinusal y orbitaria por adenocarcinoma de próstata" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 619 "Ancho" => 2458 "Tamanyo" => 250487 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Anatomopathology of the ethmoid sample. (A) hematoxylin-eosin. (B and C) immunohistochemistry with positive reaction for (B) PAP and (C) NKX3.1.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">When prostate adenocarcinoma metastasizes to the sinonasal and orbital regions, it is generally characterized by being poorly differentiated and carries an unfavorable prognosis. It is postulated that, via the vertebral venous plexus, cancer cells can reach the head and neck through lymphatic or hematogenous pathways.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A total of 80% men diagnosed with prostate adenocarcinoma have bone metastases. In radiographic descriptions, most of these are categorized as osteoblastic. The pathogenesis of dysregulation in osteosynthesis is under study, and it is believed that various factors, such as the synthesis of prostate-specific antigen (PSA), could be related.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In this article, we present the case report of a patient with a past medical history of prostate adenocarcinoma and symptoms associated with sinusitis, showing extensive involvement of the paranasal sinuses, skull base, and orbit due to a soft tissue density mass, without evidence of osteoblastic involvement at this level. This form of presentation proved to be a diagnostic challenge, requiring the processing of anatomopathological samples to determine the appropriate therapeutic approach.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Case report</span><p id="par0020" class="elsevierStylePara elsevierViewall">A 77-year-old male was referred from another medical center due to binocular diplopia and unilateral palpebral ptosis, along with a 20-day history of holocranial headache with an intensity of 10/10. The medical history included a diagnosis of stage IV prostate adenocarcinoma on hormone therapy. Additionally, he had previously undergone radical prostatectomy and radiotherapy several years prior. Currently, he also had hypertension under treatment and was on inhaled corticosteroids due to a recent diagnosis of sinusitis with nasal polyposis.</p><p id="par0025" class="elsevierStylePara elsevierViewall">For the past 6 months, the patient had sustained and rising serum PSA levels above the established upper limit, prompting new imaging modalities. At the time of consultation, the PSA level had reached 187 mg/dL. Imaging modalities performed at the referring center showed multiple osteoblastic lesions affecting the costal arches and vertebral levels T7 and L1, as well as focal lesions in the liver, interpreted as metastases.</p><p id="par0030" class="elsevierStylePara elsevierViewall">On the ophthalmological examination, the best-corrected visual acuity was recorded as finger counting at 2 m in the right eye and 20/20 in the left eye. Complete palpebral ptosis was observed in the right eye, with non-reactive mydriasis and a frozen orbit (abolition of all ocular movements). Fundoscopic examination was normal, without evidence of papilledema or other pathological findings. Hypoesthesia was noted in the right frontal and maxillary regions. Optical coherence tomography (OCT) showed no macular or papillary abnormalities (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Following an oncology consultation, it was determined that new neuroimaging focusing on the right cavernous sinus and sphenoidal regions was warranted, with contrast-enhanced computed tomography (CT) being the first choice given the patient’s oncological history. The new brain CT revealed a soft tissue density mass after the administration of contrast enhancement over the tubercle of the sella turcica, infiltrating laterally into the cavernous sinuses, predominantly on the right side, creating a mass effect on the ipsilateral optic nerve and narrowing it at the orbital apex. In the bone window, this mass also compromised the ethmoidal cells, destroying them and extending to the turbinates and right maxillary sinus, completely eroding the medial wall of the latter. Mucosal occupation and peripheral thickening of the sphenoidal sinus were observed, with a restrictive pattern on diffusion in the magnetic resonance imaging (MRI). Additionally, thickening of the proximal portion of the extraocular muscles was visualized in the right orbit, predominantly of the lateral rectus (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Blood cultures and lumbar puncture yielded no positive results. Given the previous diagnosis of stage IV prostate adenocarcinoma, and with neuroimaging modalities being conducted to assess possible metastatic spread, the need for further additional studies such as positron emission tomography (PET) was dismissed. For diagnostic confirmation, samples were taken through endoscopic sinonasal surgery from the middle turbinate, polypoid nasal degeneration, anterior and posterior ethmoid, and sphenoid. The anatomopathological study revealed chorion infiltration by neoplastic cells with mild nuclear pleomorphism, a prominent nucleolus, and eosinophilic cytoplasm arranged in glandular and cribiform patterns. Immunohistochemistry was positive for the following markers: prostatic acid phosphatase (PAP), cytokeratin 20 (CK20), homeobox protein NKX3.1 (NKX3.1), and PSA. This immunostaining profile was initially interpreted as infiltration by adenocarcinoma of prostatic origin (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">After a joint review of the case with Oncology, and considering all the above-mentioned findings, a diagnosis of painful ophthalmoplegia due to stage IV TNM prostate adenocarcinoma was established, with metastasis in the paranasal sinuses and extension to the right orbit. Since lesions were unresectable, chemotherapy with docetaxel and radiotherapy to the skull base and right orbit were initiated.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Discussion</span><p id="par0050" class="elsevierStylePara elsevierViewall">The clinical presentation that prompted the patient's consultation was interpreted as painful ophthalmoplegia of the right eye. In light of this diagnosis, is relevant to consider conditions requiring emergency treatment, such as internal carotid artery aneurysm, giant cell arteritis, or mucormycosis infection.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Due to the involvement of cranial nerves II, III, IV, V1, V2, and VI, it was inferred that the lesion was located in the right orbital apex or the homonymous cavernous sinus extending into the latter³.</p><p id="par0055" class="elsevierStylePara elsevierViewall">In this clinical case report, neuroimaging revealed sinonasal and orbital lesions consistent with metastases, atypical in both location and non-osteoblastic nature. Instead of increased bone density, various degrees of bone resorption and osteolysis were evident, along with a soft tissue density mass that enhanced with IV contrast and showed restricted diffusion.</p><p id="par0060" class="elsevierStylePara elsevierViewall">This imaging presentation led to multiple differential diagnoses of neoplastic etiology, such as lymphoproliferative disorders and adenoid cystic carcinoma,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> inflammatory conditions like IgG4-related disease, inflammatory pseudotumor, and sarcoidosis, and infectious causes such as fungal sinusitis.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> However, given the patient's past medical history of stage IV prostate adenocarcinoma, secondary spread was the most probable diagnosis, and biopsy sample processing was crucial for confirmation.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Sinonasal disease should not be underestimated, especially in patients with a cancer history. The patient had reported previous discomfort and was empirically treated for sinusitis without confirming the etiology of the sinusopathy.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a> Pathological confirmation of disease progression, even on an oral androgen receptor inhibitor,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> was necessary to escalate therapy to radiotherapy and chemotherapy with taxanes.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Docetaxel has been shown to improve survival in patients with castration-resistant prostate adenocarcinoma. Additionally, poly (ADP-ribose) polymerase (PARP) inhibitors such as niraparib—currently being studied for this stage—are promising.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conclusions</span><p id="par0070" class="elsevierStylePara elsevierViewall">In a patient with a cancer history, especially in advanced stages of the disease, the appearance of signs and symptoms in other organs and/or systems could be due to metastatic activity. Secondary spread should be prioritized as part of the differential diagnosis and confirmed through pathological processing.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres2274528" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Context" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1895643" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres2274529" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1895644" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Case report" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conclusions" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2024-05-02" "fechaAceptado" => "2024-08-09" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1895643" "palabras" => array:5 [ 0 => "Painful ophthalmoplegia" 1 => "Prostate adenocarcinoma" 2 => "Sinonasal metastases" 3 => "Non-osteoblastic lesions" 4 => "Bone metastatic infiltration" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1895644" "palabras" => array:5 [ 0 => "Oftalmoplejía dolorosa" 1 => "Adenocarcinoma de próstata" 2 => "Metástasis rinosinusales" 3 => "Lesiones no osteoblásticas" 4 => "Infiltración ósea metastásica" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Context</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Bone metastases from prostate adenocarcinoma usually present osteoblastic characteristics in imaging studies.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Method</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Case report.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A 77-year-old patient diagnosed with prostate adenocarcinoma with osteoblastic metastases in the dorsal spine and ribs, empirically treated with decongestants for symptoms associated with nasal polyposis, presented with binocular diplopia and ptosis of the right eyelid. Painful ophthalmoplegia and ipsilateral frozen orbit were observed. CT scan revealed a soft tissue density neoformation infiltrating the paranasal sinuses and extending to the skull base and extraocular muscles. Biopsy by endoscopic sinus surgery allowed for the diagnosis of metastasis.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Regardless of the characteristics evident in imaging studies, the onset of symptoms in other organs and systems in patients with a history of prostate adenocarcinoma should prompt the histopathological study of the lesions.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Context" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Antecedentes</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Las metástasis óseas del adenocarcinoma de próstata suelen presentar características osteoblásticas en los estudios por imágenes.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Método</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Reporte de un caso.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Paciente de 77 años con diagnóstico de adenocarcinoma de próstata con metástasis de características osteoblásticas en columna dorsal y costillas, en tratamiento empírico con descongestivos por síntomas asociados a poliposis nasal, consultó por diplopía binocular y ptosis palpebral del ojo derecho. Se constató oftalmología dolorosa y órbita congelada ipsilateral. En la TC se evidenció una neoformación con densidad de partes blandas que infiltraba los senos paranasales y se extendía a base de cráneo y músculos extraoculares. La toma de biopsia por cirugía endoscópica rinosinusal permitió arribar al diagnóstico de secundarismo.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Independientemente de las características evidenciables en los estudios por imágenes, el inicio de síntomas a nivel de otros órganos y sistemas en pacientes con antecedentes de adenocarcinoma de próstata debe motivar el estudio anatomopatológico de las lesiones.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1055 "Ancho" => 2458 "Tamanyo" => 281410 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Nine diagnostic gaze positions. Abolition of extraocular movements, ptosis, and proptosis of the right eye.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 705 "Ancho" => 2458 "Tamanyo" => 173344 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">CT of the orbits with IV contrast. Left: thickening of the proximal portion of the extraocular muscles, predominantly of the lateral rectus, and post-contrast enhancement (arrowhead). Center: enlargement of the right cavernous sinus (arrow) and involvement of the sphenoidal sinus. Right: bone window showing bone destruction of the ethmoidal cell septa and maxillary sinus walls.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 619 "Ancho" => 2458 "Tamanyo" => 250487 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Anatomopathology of the ethmoid sample. (A) hematoxylin-eosin. 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