Sinonasal Undifferentiated Carcinoma Of The Left Maxilla

ABSTRACT

undifferentiated carcinoma(SNUC)is an uncommon aggressive malignancy of the nasal cavity and paranasal sinuses. Since the initial recognition of SNUC as a distinct clinicopathological entity, treatment regimens have evolved to include the current recommendation of combined radical resection,radiotherapy and chemotherapy. Despite this aggressive therapy,outcomes have remained dismal, with the mean survival time still being less than 1 year after diagnosis. SNUC present with locally advanced disease, with a tendency for the tumor to spread from the paranasal siuses to the orbit and anterior cranial fossa. A case of SNUC occurred in the left maxilla showing an unusual clinical manifestations and a fulminant course of disease, is described with literatures review. A 77-year-old female patient presented with rapidly growing tumor-like bulging of the left maxilla and slight ulceration of the right upper posterior vestibule. At the first biopsy,diagnosis was a radicular cyst, but SNUC was made subsequently by the second biopsy 6 month later.Rapid and wide extension from the maxilla to the orbit and nasal cavity developed with infection. Although the time relationship is not clear,local invasion could be developed from localized disease of SNUC. Despite combined therapy with chemotherapy and radiotherapy, She has been expired 13 months after the first biopsy. Focal positivity of immunohistochemical stain (CK,EMA), which is a specific characteristic of SNUC, may serve as a factor showing unfavorable prognosis.