Colliding Tumor of the Paranasal Sinus

Abstract

Sinonasal malignant neoplasms comprise only 3% of all head and neck malignancies. Synchronous and metachronous tumors of the head and neck have been described, but rarely have there been reports of a single tumor with two distinct histologies. Here, we describe a case of a sinonasal malignant neoplasm with two distinct histologies. A case report and literature review was performed. We present a case of paranasal sinus neoplasm involving two malignant cell types. An 83-year-old woman presented with a 2-year history of symptoms suggestive of chronic sinusitis, which included nasal congestion and intermittent midface pressure. More recently, her symptoms progressed with the development of left-side epistaxis and she was found to have a mass in the left maxillary and ethmoid regions. A biopsy of the maxillary sinus mass revealed a moderately differentiated squamous cell carcinoma (SCC). She underwent complete resection of the lesion through an extended endoscopic approach. Final pathological analysis showed a malignant neoplasm with two distinct malignant morphologies; a moderately differentiated SCC and small cell neuroendocrine carcinoma. Appropriate diagnosis and treatment of head and neck malignancy depends on accurate tumor classification and staging. We present a case of a sinonasal tumor with two distinct malignant entities and review the available literature on the subject. Additionally, we discuss the etiologic theories and challenges in planning the optimal approach to management in this scenario.

Primary Combined Neuroendocrine and Squamous Cell Carcinoma of the Maxillary Sinus: Report of a Case with Immunohistochemical and Molecular Characterization

“…Here, they represented approximately 10 % of all neuroendocrine carcinomas and consisted of a combination of squamous cell and small cell carcinoma or atypical carcinoid [2,3]. In the few cases reported in the sinonasal tract, the neuroendocrine carcinoma was more frequently combined with an adenocarcinoma not otherwise specified or with intestinal type adenocarcinoma, while inverted papilloma was associated in one instance [4], and squamous cell carcinoma in two instances [5,6]. The present case consisted of a combination of well-differentiated squamous cell carcinoma and large cell neuroendocrine carcinoma.…”

“…In the head and neck region, these tumors occur more frequently in the larynx, where they represent approximately 10 % of all neuroendocrine carcinomas [2,3]. In the sinonasal tract only few examples have been reported, which consisted mostly of a combination of adenocarcinoma and neuroendocrine carcinoma [4], while cases of combined small cell and squamous cell carcinoma seem to be exceedingly rare [5,6].…”

Collision tumor of small cell carcinoma and squamous cell carcinoma of the maxillary sinus: Case report

“…In the head and neck region, the collision of neuroendocrine tumors is uncommon. Only a small number of cases in the oral region and sinonasal area have been reported (3,5,6). This occurrence has been reported more frequently in the larynx (7).…”

“…The genitourinary and gastrointestinal systems are the most common sites (2). In the maxillary sinuses, the most common malignancy is squamous cell carcinoma (SCC), followed by adenocarcinoma (3,4). SmCC is a highly aggressive tumor with high recurrence rates and propensity for distant metastasis, hence its poor prognosis (4).…”

Clinical effects of p53 overexpression in squamous cell carcinoma of the sinonasal tract

“…As one of the most uncommon malignant diseases, malignant neoplasms of the sinonasal tract account for approximately 0.3% of all cancers, and about 3% of head and neck carcinomas, [1,2] with an overall incidence rate of 0.5 to 1.0 cases per 100,000 population annually. [3] The most common histological subtypes in the nasal sinuses are squamous cell carcinoma (SCC) and adenocarcinoma.…”