Metastatic Sinonasal and Right Orbital Adenocarcinoma Secondary to Right Breast Lesion

Matthew P. Nemoy; Macksood Aftab, DO, MHA, ALM, CAQ


Appl Radiol. 2019;48(2):32-33. 

In This Article

Imaging Findings

A CT scan of the brain exhibited mucosal thickening in the maxillary sinuses and complete opacification of the frontal sinuses and right ethmoid sinuses. Walls of the right ethmoid sinuses appeared thin. Mucosal thickening of the left ethmoid sinuses as well as complete opacification of the right sphenoid sinus were noted. There was right mastoid air cells opacification and partial opacification of the left sphenoid sinus.

A CT scan of the sinuses without contrast revealed hyperdense soft tissue opacifying the right sphenoid sinus extending to the right posterior ethmoidal air cells with osseous erosive changes; erosion of the right anterior wall of the sphenoid sinus, posterior right ethmoidal air cell septi; and mild erosion of the posterior medial walls of the maxillary sinus and medial wall of the orbit with minimal soft tissue extending to the orbital apex. Erosion of the left cribriform plate was noted. Further, there was opacification of the right mastoid air cells, left sphenoid sinus and bilateral frontal sinuses.

An MRI scan of the brain with and without contrast revealed mucosal thickening and fluid throughout the paranasal sinuses. The thickening extensively involved the right mastoid air cells, bilateral sphenoid sinuses, and frontal sinuses. Additionally, osseous destructive change and associated low T2 signal soft tissue involving the right anterior sphenoid sinus and adjacent ethmoidal septa was noted.