[Ethmoidal metastasis revealing lung adenocarcinoma]

Ethmoidal cancers are rare and are mostly primitive adenocarcinomas. Sinuso-nasal metastases from adenocarcinoma occurring in other localisations are exceptional. We report a case of a patient presenting with an ethmoidal metastasis revealing a pulmonary adenocarcinoma.

A 57 years-old patient consulted for a right fronto-orbital pain which had appeared 3 weeks prior, associated with a central scotoma of the right eye and a third and fifth cranial nerve palsy. MR-imaging revealed a right ethmoidal tumour invading the orbit. Pathology results were in favour of a metastasis from a secondary adenocarcinoma. The CT-scan disclosed a pulmonary tumour of the right apex with liver and spleen metastasis.

Ethmoidal metastases are rare and often diagnosed in patients presenting with a previously known tumour. We report the first case of a pulmonary adenocarcinoma revealed by an ethmoidal metastasis. We emphasize the point that in ethmoidal tumours, pathological investigations are important for diagnosis.