3.8 Article

Recurrent adenocarcinoma of the sinonasal tract

Journal

ORAL AND MAXILLOFACIAL SURGERY-HEIDELBERG
Volume 17, Issue 2, Pages 155-158

Publisher

SPRINGER HEIDELBERG
DOI: 10.1007/s10006-012-0342-9

Keywords

Recurrent low-grade nasal adenocarcinoma; Sinonasal primary malignant tumour; Benign adenoma; Endoscopic surgery; Radical maxillectomy

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Background Adenocarcinomas arising from the nasal cavity and paranasal sinus are malignant tumours that are not of minor salivary gland origin, and they do not demonstrate histopathological features of sinonasal intestinal-type adenocarcinoma. These adenocarcinomas are divided into lowand high-grade subtypes. We herein present a case to highlight the significance of a correct histological diagnosis for treatment and follow-up. Case report We report a case of a recurrent low-grade adenocarcinoma arising in the left nasal cavity and extending to the ethmoid, maxillary sinus and orbital floor. No facial deformity or proptosis was present. The diagnosis was made by analysis of a sample taken by biopsy and CT-MRI. We performed a radical maxillectomy and reconstruction with a temporalis muscle flap and a titanium mesh for the orbital floor. Discussion Low-grade adenocarcinomas of the sinonasal tract are a challenge for the pathologist to differentiate from benign adenomas and high-grade adenocarcinomas, but the distinction is important because the treatment and prognosis differ. Treatment success is determined by complete surgical excision. We also suggest the usefulness of PET to detect recurrence during follow-up.

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