Acute phantosmia as the first manifestaton of brain metastases in a patient with breast cancer. Case report

TL;DR

A patient with breast cancer developed sudden phantosmia, which led to the discovery of brain metastases, highlighting the importance of early detection and multidisciplinary care.

Contribution

This case report highlights phantosmia as a rare but significant early indicator of brain metastases in breast cancer patients.

Findings

Phantosmia was the first sign of brain metastases in a patient with metastatic breast cancer.

Whole brain irradiation and medications effectively managed the patient's condition.

A multidisciplinary approach is essential for diagnosing and treating phantosmia in cancer patients.

Abstract

Phantosmia belongs to the group of olfactory dysfunctions. It is more commonly described in psychiatric conditions and some cases of viral infections, but it has been also rarely described in cancer patients who develop primary or metastatic central nervous system tumors; the early identification of this symptom in this population is crucial, as it could lead to timely diagnosis and treatment through a multidisciplinary approach.

With the current report we present the case of a 60-year-old lady with metastatic breast cancer and without known preexisting brain metastases, who developed acute phantosmia without other neurological deficits; computed tomography of the brain revealed multiple brain metastases, which were attributed to the malignancy, and for which she was effectively treated with whole brain irradiation and antipsychotic as well as anticonvulsant medications. Furthermore, we underline the value of cooperation between the various specialties that could aid in diagnosis and management of this symptomatology.

Phantosmia is an extremely rare symptom in cancer patients, and its appearance should alarm physicians to rapidly investigate a possible progression of disease in the central nervous system. Multidisciplinary approach is needed for the optimal management of these patients.

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