Overview
Metastatic malignant neoplasm to the vomer refers to the spread of cancer from another primary site to the vomer, a bone forming the posterior part of the nasal septum. This is a rare occurrence, often associated with advanced stages of primary cancers.Diagnosis
Diagnosis typically involves imaging studies (e.g., CT, MRI) to visualize the extent of the lesion and biopsy for histopathological confirmation.
Next-generation sequencing (NGS) of tumor tissue may be considered in patients with advanced cancers, particularly for rare tumors or cancers of unknown primary, to identify actionable molecular alterations 1.Management
Management strategies for metastatic disease are generally guided by the primary cancer type and molecular profiling.
Tumor NGS is recommended for patients with advanced cancers, including rare tumors, to detect tumor-agnostic alterations where matched therapies are available 1.
ESMO recommends tumor NGS for advanced non-squamous non-small-cell lung cancer, prostate cancer, colorectal cancer, cholangiocarcinoma, and ovarian cancer 1.
Expansion of NGS recommendations includes advanced breast cancer and rare tumors such as gastrointestinal stromal tumors, sarcoma, thyroid cancer, and cancer of unknown primary 1.Key Recommendations
Tumor NGS is recommended for patients with advanced non-squamous non-small-cell lung cancer, prostate cancer, colorectal cancer, cholangiocarcinoma, and ovarian cancer 1. (Evidence: Expert opinion)
Tumor NGS should be carried out in clinical research centers and under specific circumstances discussed with patients 1. (Evidence: Expert opinion)
Tumor NGS is recommended to detect tumor-agnostic alterations in patients with metastatic cancers where access to matched therapies is available 1. (Evidence: Expert opinion)
The scope of tumor NGS recommendations has expanded to include advanced breast cancer and rare tumors such as gastrointestinal stromal tumors, sarcoma, thyroid cancer, and cancer of unknown primary 1. (Evidence: Expert opinion)References
1 Mosele MF, Westphalen CB, Stenzinger A, Barlesi F, Bayle A, Bièche I et al.. Recommendations for the use of next-generation sequencing (NGS) for patients with advanced cancer in 2024: a report from the ESMO Precision Medicine Working Group. Annals of oncology : official journal of the European Society for Medical Oncology 2024. link