Undifferentiated Sinonasal Carcinoma with Lymph Node Metastases: A Case Report

Case Report

Austin J Otolaryngol. 2023; 9(1): 1130.

Undifferentiated Sinonasal Carcinoma with Lymph Node Metastases: A Case Report

Bencheikh; Benbouzid; Oujilal; Essakalli; Noureddine J*

Avicenne University Hospital Center, Specialized Hospital, Morocco

*Corresponding author: Jelloul Noureddine Department of Otolaryngology Head and Neck Surgery, Specialized Hospital, AVICENNE University Hospital Center, Rabat, Morroco. Email: noureddinejelloul00@gmail.com

Received: November 13, 2023 Accepted: December 21, 2023 Published: December 28, 2023

Keywords: Undifferentiated sinonasal carcinoma; Imaging; Immunohistochemistry; Surgery; Lymph node dissection; Radiochemotherapy

Introduction

Undifferentiated sinonasal carcinoma (SNUC) is a rare malignant tumor that originates from the Schneiderian membrane lining the nasal cavities and paranasal sinuses. It often presents with rhinological symptoms, while other ocular or neurological signs can be either initial or secondary manifestations [1,2]. CT and MRI provide precise locoregional assessment [2,14]. Diagnosis relies on anatomopathological examination [2,3], and the treatment primarily involves surgery and radiochemotherapy (RECFOR.4). This tumor poses management challenges due to its typically late diagnosis and significant extent, which can hinder complete tumor resection. This study aims, along with a literature review, to outline the histoclinical characteristics of SNUC, revisit prognostic factors, and establish an appropriate therapeutic approach for this tumor.

Materials and Methods

Clinical Case

We present the case of a 70-year-old female patient with no significant medical history, admitted due to rhinosinusitis symptoms dominated by left-sided nasal obstruction accompanied by recurrent ipsilateral epistaxis evolving for 2 months. Nasal endoscopy revealed a budding process within the left nasal cavity, straddling the inferior and middle turbinates and curving along the posterior edge of the nasal septum.

Cervical examination identified multiple bilateral laterocervical lymph nodes. Neurological and ophthalmological examinations were unremarkable. The rest of the ENT examination showed no particular findings.

Facial CT scan exhibited a tissue-density lesion within the left nasal cavity, showing discrete enhancement after contrast agent injection. The lesion straddled the middle and inferior turbinates without expansion into the choanal or associated bone lysis (Figure 1).