ABSTRACT
It is rare for neuroendocrine tumours to originate in the sphenoid sinus and the nasopharynx. Neuroendocrine tumours can be classified into typical carcinoids, atypical carcinoids and small cell neuroendocrine carcinomas. Here we report the case of a 48-year-old man with a typical carcinoid tumour of the nasopharynx and sphenoid sinus. This is a very rare diagnosis, and only a few cases of a typical carcinoid in this region have been described in the literature.
Subject(s)
Carcinoma, Neuroendocrine/diagnosis , Nasopharyngeal Neoplasms/diagnosis , Paranasal Sinus Neoplasms/diagnosis , Sphenoid Sinus , Carcinoma, Neuroendocrine/blood , Carcinoma, Neuroendocrine/drug therapy , Carcinoma, Neuroendocrine/radiotherapy , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Nasopharyngeal Neoplasms/blood , Nasopharyngeal Neoplasms/drug therapy , Nasopharyngeal Neoplasms/radiotherapy , Paranasal Sinus Neoplasms/blood , Paranasal Sinus Neoplasms/drug therapy , Paranasal Sinus Neoplasms/radiotherapy , Positron-Emission Tomography , Radiotherapy, AdjuvantABSTRACT
A 55-year-old male presented with left-sided otorrhoea, hearing loss and tinnitus of 3 months duration. On clinical examination polypoid tissue was seen prolapsing in the external ear canal. A CT scan of the mastoid cells and middle ear showed otomastoiditis with osteolysis. Oral antibiotic therapy and eardrops were started. When a facial nerve paresis appeared one month later, a mastoidectomy was performed. The mastoid cells and middle ear were filled with a connective tissue-like substance. Postoperative corticosteroids were administered. Despite the therapy the facial nerve problem aggravated and the patient developed severe parietotemporal headache, meningeal irritation and somnolence. The diagnosis of neurosarcoidosis was hypothesised. Blood analysis, including c-ANCA's, culture of the otorrhoea and biopsies of the connective tissue were inconclusive. A CT scan of the brain showed thickening of the left tentorium. A biopsy of the dura indicated a diagnosis of Wegener's granulomatosis. The patient was treated with immunosuppressive medication with satisfactory results.
