Case History of Tumor Research

Introduction

Although the nasal cavity and paranasal sinuses occupy a relatively small anatomical space, they are the site of origin of some of the more complex, histologically diverse group of tumours in the entire human body. Carcinomas of the nasal cavity and paranasal sinuses account for 0.2-0.8% of all malignant neoplasms and 3% of those occurring in the head and neck. Sinonasal undifferentiated carcinoma is a highly aggressive and clinicopathologically distinctive carcinoma of uncertain histogenesis that typically presents with locally extensive disease [1]. It was first reported by Frierson et al. [2]. SNUC affects more males (2-3:1) with a broad age range (third to ninth decade), and the median age is in the sixth decade.

In our case, a 50 yr old female came to the ENT OPD on Sept, 2014 with increased respiratory difficulty; discharge from the eyes and with pain in the nose and eyes. She was on herbal medicines for 1 yr (Figure 1). Clinician on examination found a mass over right nasal cavity. CECT showed an enhancing mass lesion in the right nasal cavity and right maxillary sinus. Excision of mass was done by right lateral rhinotomy.

Gross examination showed grayish white tissue with solid areas of haemorrhage. Histopathological examination of A and B section from the tissue showed elongated cells with a cylindrical or columnar appearance, oriented perpendicular to the surface, without any evidence of keratinisation. The picture was consistent with transitional cell carcinoma (non-keratinizing squamous cell carcinoma) with areas of haemorrhage and necrosis (Figure 2). After a period of 6 months, patient again presented with bleeding nose. Clinician on examination found features of epistaxis. Following which CECT was done, which showed heterogeneously enhancing sinonasal mass lesion involving right maxillary sinus and nasal cavity along with its regional extension. Features suggested possibility of the following –D/D- Inverted papilloma or malignant mass.

Best Regards:
Mary Wilson
Journal Manager
Journal of Tumor Research
Email: tumour@medicalresjournals.com