PDF(Pubmed)
Abstract：
BACKGROUND: Intestinal adenocarcinoma accounts for less than 0.1-4% of all malignancies in the region. It is common among woodworkers and leather workers. Sinonasal adenocarcinoma usually arises from the ethmoid sinus (40%) or nasal cavity (25%). Extension to nearby structures is common, but intracranial spread is very rare. These tumors are usually treated with surgery, with a reported 5-year survival rate of 59% to 80%.
METHODS: This is a 60-year-old Black African male patient who presented with globalized headache, nasal obstruction with snoring during sleep, anosmia, change in mentation, sometimes agitation and left-side visual loss of one-year duration with worsening his above symptoms over the last one month. He couldn\'t smell soap bilaterally; in his left eye he could see only hand movement at nearly 30 cm. On brain magnetic resonance imaging, there was a T1 hypo- and T2 hyper-intense anterior cranial fossa mass arising from the left ethmoid sinuses and sphenoid sinuses and compressing the left optic structures, and brain computed tomography demonstrated heterogeneous hypo- to isodense mass. Complete tumor excision achieved and discharged with significant improvement and linked to oncology unit for radiotherapy.
CONCLUSIONS: The management of these patients is multidisciplinary, involving neurosurgeons, otolaryngologists, oncologists, and maxillofacial surgeons. Surgical resection is the main treatment strategy, followed by radiotherapy, particularly intensity-modulated therapy. Chemotherapy is used in highly advanced, metastatic, and unresectable tumors.
METHODS: This is a 60-year-old Black African male patient who presented with globalized headache, nasal obstruction with snoring during sleep, anosmia, change in mentation, sometimes agitation and left-side visual loss of one-year duration with worsening his above symptoms over the last one month. He couldn\'t smell soap bilaterally; in his left eye he could see only hand movement at nearly 30 cm. On brain magnetic resonance imaging, there was a T1 hypo- and T2 hyper-intense anterior cranial fossa mass arising from the left ethmoid sinuses and sphenoid sinuses and compressing the left optic structures, and brain computed tomography demonstrated heterogeneous hypo- to isodense mass. Complete tumor excision achieved and discharged with significant improvement and linked to oncology unit for radiotherapy.
CONCLUSIONS: The management of these patients is multidisciplinary, involving neurosurgeons, otolaryngologists, oncologists, and maxillofacial surgeons. Surgical resection is the main treatment strategy, followed by radiotherapy, particularly intensity-modulated therapy. Chemotherapy is used in highly advanced, metastatic, and unresectable tumors.
摘要：
背景：肠腺癌占该地区所有恶性肿瘤的不到0.1-4％。这在木工和皮革工人中很常见。鼻窦腺癌通常起源于筛窦（40％）或鼻腔（25％）。延伸到附近的结构是常见的，但是颅内扩散非常罕见。这些肿瘤通常用手术治疗，报告的5年生存率为59％至80％。
方法：这是一名60岁的黑人非洲男性患者，他出现了全球性头痛，睡眠时鼻塞伴有打鼾，嗅觉缺失,心理变化，有时躁动和左侧视力丧失持续一年，并在过去一个月内恶化上述症状。他不能闻到肥皂两侧;在他的左眼，他只能看到手的运动在近30厘米。在脑磁共振成像中，有一个T1低和T2高强度的前颅窝肿块，由左筛窦和蝶窦引起，并压迫了左光学结构，脑计算机断层扫描显示出异质的低密度到等密度的肿块。完成肿瘤切除并出院，并有显着改善，并与肿瘤单位进行放射治疗有关。
结论：这些患者的管理是多学科的，涉及神经外科医生，耳鼻喉科医师,肿瘤学家,还有颌面外科医生.手术切除是主要的治疗策略,其次是放射治疗，特别是强度调节疗法。化疗的使用非常先进，转移性，和不可切除的肿瘤。
方法：这是一名60岁的黑人非洲男性患者，他出现了全球性头痛，睡眠时鼻塞伴有打鼾，嗅觉缺失,心理变化，有时躁动和左侧视力丧失持续一年，并在过去一个月内恶化上述症状。他不能闻到肥皂两侧;在他的左眼，他只能看到手的运动在近30厘米。在脑磁共振成像中，有一个T1低和T2高强度的前颅窝肿块，由左筛窦和蝶窦引起，并压迫了左光学结构，脑计算机断层扫描显示出异质的低密度到等密度的肿块。完成肿瘤切除并出院，并有显着改善，并与肿瘤单位进行放射治疗有关。
结论：这些患者的管理是多学科的，涉及神经外科医生，耳鼻喉科医师,肿瘤学家,还有颌面外科医生.手术切除是主要的治疗策略,其次是放射治疗，特别是强度调节疗法。化疗的使用非常先进，转移性，和不可切除的肿瘤。
