Extensive Cerebral Venous Thrombosis In A Patient With Sinonasal Undifferentiated Carcinoma (SNUC) With A Dural-Based Metastasis

Jalan P* , Pradhan A **, Omar A***

Abstract

Sinonasal undifferentiated carcinoma (SNUC) is a rare and aggressive neoplasm that typically arises in the sinonasal cavities often with intracranial extension. Venous sinus thrombosis has been described in association with systemic malignancies as well as following cisplatin therapy but has never been reported in association with this tumour. A 43 year old presented with right facial pain and nasal stuffiness. Subsequently he was diagnosed of a ethmoid mass with right orbital and anterior cranial fossa extension following computed tomography scan and underwent chemo-radiation therapy. Months later he developed seizure and a right parietal dural metastasis with skull invasion. A venogram revealed extensive venous sinus thrombosis involving the superior sagittal as well as the transverse sinus. This is the first report of venous sinus thrombosis in a patient with SNUC. The etiology of the venous sinus thrombosis in this case, maybe a combination of cisplatin therapy, the underlying malignancy and possibly compression of the sagittal sinus by the dural and skull metastasis.

Keywords: Sinonasal Undifferentiated Carcinoma, Dural Metastasis, Cerebral Venous Thrombosis, Venogram, Cisplatin, Radiotherapy

* Pankaj Jalan MBBS, MD, DABPN Consultant Neurologist, Norvic International Hospital, Kathmandu, Nepal
** Akesh Pradhan MBBS, Department of Neurology,Norvic International Hospital,Kathmandu, Nepal
*** Ayman Omar, MD, PhD, LMCC, MSc (Oxon), DABPN,Medical Director, Neurology Inpatient Program
Neurologist, NeuroOncologist and Specialist in Endovascular Neurosurgery,Wellington Regional Medical Center,Wellington, FL,USA

Correspondence: ineurology@yahoo.com (Jalan P)

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