An extremely rare case report of sinonasal undifferentiated carcinoma of paranasal sinuses

Abstract

Sinonasal undifferentiated carcinoma (SNUC) of the paranasal sinuses represents a very rare and extremely aggressive malignancy posing a diagnostic and therapeutic dilemma for treating physicians due to its location, vast array of differential diagnosis without any definite therapeutic guideline. With only a few cases described in the literature, we hereby report a 34-year-old male with progressive, painless swelling of the left eye and diminution of vision. Radiographic imaging showed a mass lesion in the left anterior ethmoid sinus. Biopsy of nasal mass seen on nasal endoscopy revealed a poorly differentiated malignancy. He underwent craniotomy and excision of tumor. Postoperative histopathology report showed SNUC staining positive for epithelial membrane antigen, neuron-specific enolase, and cytokeratin on immunohistochemistry. He received postoperative radiotherapy (RT) and chemotherapy but developed extensive skeletal metastasis, for which he was treated with palliative RT to which he responded well. At present, he was on close follow-up with a Karnofsky performance status of 60%.

Keywords

• Chemotherapy
• palliation
• paranasal sinuses
• radiotherapy
• sinonasal undifferentiated carcinoma