Adenocarcinoma of the ethmoid sinus

Abstract

Obtaining clear margins by craniofacial resection is essential to the management of adenocarcinoma of the ethmoid sinuses. Radiotherapy is reserved for positive margins, cribriform plate penetration, dural invasion, and high-grade lesions that are close to the cribriform plate. Local control was obtained in 87% of our patients.

Primary Ethmoidal Sinus Oncocytic Adenocarcinoma Presenting as Proptosis

“…The majority of these carcinomas originate in the maxillary sinuses. Primary ethmoidal carcinomas account for only 20% of all paranasal sinus malignancies [2, 3, 4, 5], with adenocarcinomas accounting for just 4% of all malignancies of the nose and sinuses, but for 40% of all carcinomas of the ethmoid sinuses [6, 7]. Because of the rarity of both a diagnosis of primary oncocytic adenocarcinoma of the ethmoid, and the orbital presentation, we have reported the following case.…”

“…The predominant presenting symptoms of ethmoidal sinus adenocarcinoma are epistaxis and nasal obstruction [2, 6, 8]. The orbit lies lateral to the ethmoid sinus and is separated from the sinus by the medial orbital wall and its periosteum, making it difficult for tumour to spread directly to the orbit.…”

“…Because of the unusual nature of this case, it required alternative management from the protocol normally advised for treatment of ethmoidal sinus adenocarcinoma [6], which would otherwise involve craniofacial resection by a neurosurgical / ENT team.…”

“…However it has been suggested that MRI scan is more helpful in assessing these tumours as CT is often unable to differentiate between obstructive mucus retention in the sinus and tumour extension into the sinus cavity [6, 15]. A number of studies have demonstrated a high incidence of intracranial spread [2, 5, 8, 15, 16] and therefore craniofacial resection as a combined procedure by the ENT and neurosurgical teams is the treatment of choice [6], followed by postoperative radiotherapy in those patients with positive margins, dural invasion, or the presence of a high grade lesion with cribriform plate invasion. Orbital exenteration is performed if the periorbita is involved.…”

Prevalence of occupational hazards in patients with different types of epithelial sinonasal cancers

“…Epithelial tumours represent over two/third of the SNC and, among them, the most common histotypes are adenocarcinoma and squamous cell carcinoma (SCC) (2) with European studies showing a frequency of adenocarcinoma (3)(4)(5) higher than that reported in the corresponding Northern American studies (6,7) . Other less common sinonasal epithelial histologies are adenoid cystic cancer (ACC) and undifferentiated carcinoma (SNUC).…”