Endoscopic approach to the resection of adenoid cystic carcinoma of paranasal sinuses and nasal cavity: case report and own experience

Abstract

Adenoid cystic carcinoma (ACC) is a rare malignant tumor that might occur in nasal cavity and paranasal sinuses. It is characteristic for poor prognosis, especially the solid histopathological subtype of the tumor. ACC might spread along nerves and fascias and it is usually diagnosed at advanced stage. Computed tomography and magnetic resonance imaging together with fine-needle biopsy are the gold standards in the diagnostic procedure of the cancer. Surgery with adjuvant therapy are the most common methods of treatment. Among the surgical approaches, the functional endonasal sinus surgery seems to be the most appropriate and favorable way of treatment. In the study, the authors present a case of a 62-year-old patient with T4aN0M0 ACC tumor treated endoscopically at the Department of Laryngology and ENT Oncology, WSS No. 5 in Sosnowiec. The authors indicate the usefulness of FESS procedure in the treatment of malignancies of nasal cavity and paranasal sinuses. They also review the recent publications on endonasal versus open approach in similar cases. In conclusions, the authors favor endonasal approach as a mini-invasive method of surgical treatment of ACC of paranasal sinuses that results in satisfactory oncological outcome and high quality of patient’s life.

Renal Metastases from a Nasal Cavity Mixed Squamous Cell and Adenoid Cystic Carcinoma: A Case Report

“…This diagnostic delay and the STACC characteristic slow tumor growth could explain the large size of these neoplasms at the diagnosis. In contrast to salivary gland ACC, pain or other neurological symptoms are not commonly seen in STACC (12.8%) [17,18].…”

“…The main clinical symptoms include unilateral nasal deformation and/or obstruction, pain and recurrent epistaxis. Horner's syndrome and persistent unilateral sero-mucous otitis have been also described [17,18].…”

“…Diagnosis requires a clinical examination, CT scan and tumor biopsy for an accurate histological definition. MRI is essential for a precise assessment of tumor extension before planning the appropriate treatment [17,18]. Surgery, including endoscopic approaches, followed by conventional or neutron radiotherapy, represents the standard treatment [17][18][19][20][21][22][23].…”

Early stage adenoid cystic carcinoma of the posterior nasal septum: a rare manifestation

“…However, surgery remains the mainstay of treatment of these tumors [12]. Recently, some authors deem that surgical resection of ACC of the sinonasal tract via endoscopic approach could be an effective mini-invasive method that in well-selected patients could be satisfactorily applied, together with adjuvant therapies, giving good results, complete removal of a tumor and high surviving rate [3]. On the other hand, ACC is considered to be a radiosensitive but not radio-curable tumor.…”

“…They commonly arise within salivary glands and are characterized by slow growth, low probability of lymphatic spread, frequent local recurrences, and high incidence of distant metastasis (DM), which is even reported in patients with early stage tumors [1][2][3]. In the sinonasal tract, ACC accounts for 10-25% of all head and neck ACCs [4].…”