ABSTRACT
Sinonasal Undifferentiated carcinoma (SNUC) comprises 3% of the head and neck tumors, including metastatic neoplasms. Herein we report the case of a 60-year-old male who was brought dead to our institute with previous records of a contrast-enhanced CT scan of the brain and MRI with evidence of tumor in the maxillary sinus with intracranial extensions. The histopathological examination of the mass in the maxillary sinus proved to be SNUC with metastases to the brain, lungs, and around the aorta. These tumors are undifferentiated and are distinct from other poorly differentiated tumors in deriving their origin from the Schneiderian epithelium. The aggressive nature of the tumor renders the prognosis quite dismal. SNUCs need to be early recognized and distinguished from other poorly differentiated carcinomas with the help of immunohistochemistry.
Subject(s)
Humans , Male , Middle Aged , Maxillary Sinus Neoplasms/pathology , Carcinoma/pathology , Autopsy , Neoplasm MetastasisABSTRACT
Sinonasal undifferentiated carcinoma‑related rhinogenic optic neuropathy is rare and may lead to visual loss. To the best of our knowledge, this is the first report of bilateral sequential visual loss induced by this etiology. It is important to differentiate between chronic sinusitis and malignancy on the basis of specific findings on magnetic resonance images. Surgical decompression with multidisciplinary therapy, including steroids, chemotherapy, and radiotherapy, is indicated. However, no visual improvement was noted in this case, emphasizing the rapid disease progression and importance of early diagnosis and treatment.
ABSTRACT
Sinonasal undifferentiated carcinoma (SNUC) is a rare and highly aggressive malignant tumor arising from the schneiderian epithelium of the nasal cavity or paranasal sinuses. The presenting symptoms are diverse depending on the site involved and extent of tumor spread. The treatment of SNUC has evolved to improve overall survival rate and include disease-free control with complete surgical resection including radiotherapy and chemotherapy, but the prognosis still remains dismal. We present a patient with several months of history of intermittent nasal bleeding and stuffiness, which proved to be a rare malignant tumor of inferior turbinate origin, diagnosed as undifferentiated carcinoma of early stage in the disease process. The mass was excised en bloc with endoscopic surgical treatment from inferior turbinate without any additional combined treatment and there was no recurrence during the two-year follow-up period. We report herein, with a review of the literature, an undifferentiated carcinoma arising from the inferior turbinate, which was successfully treated by surgical resection only.
Subject(s)
Humans , Carcinoma , Drug Therapy , Epistaxis , Epithelium , Follow-Up Studies , Nasal Cavity , Paranasal Sinuses , Prognosis , Radiotherapy , Recurrence , Survival Rate , TurbinatesABSTRACT
Introduction: Malignant sinonasal tumors comprise less than 1% of all neoplasms. A wide variety of tumors occurring primarily in this site can present with an undifferentiated or poorly differentiated morphology. Among them are esthesioneuroblastomas, sinonasal undifferentiated carcinomas, and neuroendocrine carcinomas. Objectives: We will discuss diagnostic strategies, recent advances in immunohistochemistry and molecular diagnosis, and treatment strategies. Data Synthesis: These lesions are diagnostically challenging, and up to 30% of sinonasal malignancies referred to the University of Texas MD Anderson Cancer Center are given a different diagnosis on review of pathology. Correct classification is vital, as these tumors are significantly different in biological behavior and response to treatment. The past decade has witnessed advances in diagnosis and therapeutic modalities leading to improvements in survival. However, the optimal treatment for esthesioneuroblastoma, sinonasal undifferentiated carcinoma, and neuroendocrine carcinoma remain debated. We discuss advances in immunohistochemistry and molecular diagnosis, diagnostic strategies, and treatment selection. Conclusions There are significant differences in prognosis and treatment for esthesioneuroblastoma, neuroendocrine carcinoma, and sinonasal undifferentiated carcinoma. Recent advances have the potential to improve oncologic outcomes but further investigation in needed...
Subject(s)
Humans , Carcinoma, Neuroendocrine/therapy , Esthesioneuroblastoma, Olfactory/therapy , Nose Neoplasms , Review Literature as TopicABSTRACT
Sinonasal Undifferentiated Carcinoma (SNUC) is a very rare, highly aggressive malignant tumor of the nasal cavity and paranasal sinuses. SNUC tends to present with advanced-stage disease, often with intracranial invasion. It requires an aggressive multimodality therapy that includes surgical resection. A cure rate of less than 20% is generally reported in the literature, with most patients dying within 1 year of onset of the disease. Three patients diagnosed as SNUC were treated at the Yeungnam University Medical Center between the years 2000 and 2003 were analyzed retrospectively. All patients presented with the disease very advanced. The three cases were given chemotherapy or chemotherapy with radiotherapy. Two patients died of the disease, surviving only 6 and 11 months following treatment, respectively. We did a follow-up on just the one remaining case with incomplete controlled disease for 27 months. The overall prognosis of SNUC is very poor. We consider that more intensive multimodality therapies are recommended for all patients with SNUC.
Subject(s)
Humans , Academic Medical Centers , Carcinoma , Drug Therapy , Follow-Up Studies , Nasal Cavity , Paranasal Sinuses , Prognosis , Radiotherapy , Retrospective StudiesABSTRACT