[Cavernous sinus syndrome: an initial expression of a breast carcinoma]. / Síndrome del seno cavernoso como manifestación inicial de una neoplasia mamaria.

Cavernous sinus syndrome (CSS) may be caused by a wide range of pathological process among we include metastatic disease. A case of a woman whose breast neoplasm was initially expressed by a CSS is discussed in this article. We describe a 64-year-old woman with several weeks progressive course of pain and numbness in her left-side facies and occasional diplopia. Neurological examination showed left ptosis, limitation of elevation of left eye and abducens nerve palsy as well as hypoesthesia in the frontal and maxillary regions of her left-side facies. Brain magnetic resonance imaging (MRI) scan revealed the presence of a mass in the orbit and left cavernous sinus. General examination disclosed a sclerotic and retractile lesion in her left breast which involved the nipple suggesting breast carcinoma metastases. The patient underwent a breast fine-needle aspiration biopsy which established the presence of an infiltrating breast carcinoma. This case shows the importance role of the general physical examination to determine the etiology of the CSS. It is necessary and fundamental to perform it on each patient not only to orientate further investigations but also to avoid more invasive diagnostic procedures.

Síndrome del seno cavernoso como manifestación inicial de una neoplasia mamaria / Cavernous sinus syndrome: an initial expression of a breast carcinoma

El síndrome del seno cavernoso (SSC) puede ser causado por una gran variedad de procesos patológicos, entre los que se incluye la enfermedad metastásica. Discutimos aquí el caso de una mujer cuya neoplasia mamaria se inició con un SSC. Se trata de una mujer de 64 años que consultó por cuadro progresivo de dolor y parestesias en región facial izquierda y diplopía ocasional de varias semanas de evolución. En la exploración neurológica se objetivó ptosis palpebral izquierda, incapacidad para elevar y abducir el ojo izquierdo, así como hipoestesia tactoalgésica en el territorio frontal y maxilar superior de la hemicara izquierda. La tomografía computarizada y la resonancia magnética cerebrales detectaron la presencia de una masa localizada en la órbita y seno cavernoso izquierdos. La exploración general puso de manifiesto una lesión esclerosa, retráctil, en mama izquierda que englobaba el pezón, sugiriendo metástasis de una posible neoplasia mamaria. El estudio anatomopatológico de la muestra obtenida por punción aspiración con aguja fina reveló un carcinoma infiltrante de mama. Este caso ilustra la relevancia de la exploración física completa en el establecimiento de la etiología del SSC. Su realización de forma sistemática es necesaria y fundamental para, por una parte, orientar los posibles exámenes complementarios y, por otra, evitar procedimientos diagnósticos más invasivos

Cavernous sinus syndrome (CSS) may be caused by a wide range of pathological process among we include metastatic disease. A case of a woman whose breast neoplasm was initially expressed by a CSS is discussed in this article. We describe a 64-year-old woman with several weeks progressive course of pain and numbness in her left-side facies and occasional diplopia. Neurological examination showed left ptosis, limitation of elevation of left eye and abducens nerve palsy as well as hypoesthesia in the frontal and maxillary regions of her left-side facies. Brain magnetic resonance imaging (MRI) scan revealed the presence of a mass in the orbit and left cavernous sinus. General examination disclosed a sclerotic and retractile lesion in her left breast which involved the nipple suggesting breast carcinoma metastases. The patient underwent a breast fineneedle aspiration biopsy which established the presence of an infiltrating breast carcinoma. This case shows the importance role of the general physical examination to determine the etiology of the CSS. It is necessary and fundamental to perform it on each patient not only to orientate further investigations but also to avoid more invasive diagnostic procedures

Trombosis de la arteria basilar: recanalización tras la administración de heparina intravenosa evidenciada mediante angiorresonancia magnética / Basilar artery thrombosis: recanalisation following intravenous administration of heparin demonstrated by magnetic resonance angiography

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