23735              METASTATIC CARCINOMA (PRIMARY IN MAXILLARY SINUS)

This 72 year old woman presented 13 years previously with a lump in her throat.  It proved to be a carcinoma of the thyroid and this was removed.  On this occasion she presented with an 11-week history of pain in the left maxillary sinus.  X-rays revealed clouding of the maxillary antra.  Just before admission she noted swelling on the left side of her face, and also breathlessness.  Chest X-ray showed a massive left pleural effusion.

The specimen consists of the left lung sectioned to show the upper lobe entirely replaced by a very large tumour 20 cms in diameter.  Its cut surface is lobulated and divided by thick fibrous septa and there are many areas of cellular necrosis and interstitial haemorrhage.  The upper portion of the mass has broken down to form a large cavity 10 cms in diameter with ragged walls.  The remainder of the lung is collapsed but appears otherwise normal.  Histology shows a squamous carcinoma with marked keratin pearl formation.