Nasopharynx – A rare site of metastases from carcinoma breast

Abstract

We report a case of a 62-year old Indian female with a history of breast cancer treated with surgery, chemotherapy and radiation three years ago, now presenting with diplopia on the right eye for three weeks. CT showed a diffuse infiltrating lesion in the right cranial fossa. MRI reported meningeal and orbital wall involvement also. The patient was referred for 18 FDG PET/CT to assess the extent of disease and also to look for other distant metastases. 18 FDG PET/CT revealed an exact extent of lesion, from the right orbital apex, destroying greater wall of the sphenoid, extending to the nasopharynx and the right nasal cavity with extensive skeletal metastases. We present symptoms, signs and imaging modalities that aided in localization of metastases, while in the available literature such presentation of carcinoma breast secondaries in the nasopharynx is extremely rare.