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A 77-year-old-man with arterial hypertension, diabetes mellitus type II presented at our clinic for a routine ophthalmological exam. He complained of intermittent double vision. The ophthalmic examination revealed paralysis of III (n. oculomotorius) and VI (n. abducens) cranial nerves with ptosis, deficit in elevation and abduction of the left eye. The patient underwent urgent MRI imaging of the brain/orbits and paranasal sinuses, and urgent neurological assessment. MRI revealed a volume-occupying process, starting from the posterior wall of the left maxillary sinus with perineural diffusion and involvement of the homolateral trigeminal nerve, intracranial spread in the medial cranial fossa and involvement of the cavernous, sphenoidal sinuses and the orbital apex on the left side. Biopsy was performed, and the histology resulted in sinonasal squamous cell carcinoma with intracranial spread. [ABSTRACT FROM AUTHOR]

A 77-year-old-man with arterial hypertension, diabetes mellitus type II presented at our clinic for a routine ophthalmological exam. He complained of intermittent double vision. The ophthalmic examination revealed paralysis of III (n. oculomotorius) and VI (n. abducens) cranial nerves with ptosis, deficit in elevation and abduction of the left eye. The patient underwent urgent MRI imaging of the brain/orbits and paranasal sinuses, and urgent neurological assessment. MRI revealed a volume-occupying process, starting from the posterior wall of the left maxillary sinus with perineural diffusion and involvement of the homolateral trigeminal nerve, intracranial spread in the medial cranial fossa and involvement of the cavernous, sphenoidal sinuses and the orbital apex on the left side. Biopsy was performed, and the histology resulted in sinonasal squamous cell carcinoma with intracranial spread.

The oncological diagnosis represents a complex process, with several stages and a multi disciplinary approach through which we establish the existence of a neoplastic process, benign or malignant, the stage of malignancy, clinical stage and overall disease. This evaluation is important in the individual protocol therapy established for the animal patient. Each disease diagnosis requires corroborating the results from clinical investigations, but especially paraclinical methods. The oncological evaluation of the patient includes, first of all, hematological tests, blood biochemistry, urinalysis, complete endoscopic examination, ultrasound, thermography, X-ray, magnetic resonance and nuclear medicine methods, cytological and histological, endocrine, immunological and immunohistochemical markers. In the clinical context, a stage interpretation of the results confirms the nature of the proliferative process, and thus a potential therapeutic conduct. The differential diagnosis of animals' oncopathology has the same complex issues as in human oncology, in many cases clinical signs expressed in animals being atypical or insufficient to establish a certain diagnosis because of their general feature regardless of malignancy, insidious occurance, without obvious clinical manifestations to motivate diagnostic investigations. A close monitoring of the animal for a period is necessary in expectation. Periodic screening for pets over 6-7 years of age as an early way for the detection of malignancies developed de novo or for borderline lesion (border disease) is crucial for a successful treatment. It is to be avoided by any means the invasive oncological cytopathology diagnostic procedures (fine needle aspiration biopsy and incision biopsy), which should be replaced with alternative, noninvasive and conservative procedures like tumor markers, exfoliative citology and imaging evaluation, especially in cases with suspicion of malignancy developed in intense vascularized and nonencapsulated tissue. [ABSTRACT FROM AUTHOR]