‘Saddle nose’ deformity caused by advanced squamous cell carcinoma of the nasal septum

Abstract

Hidden behind their common garden symptoms, malignant tumours of the nasal cavity are typically advanced when detected. Squamous cell carcinoma (SCC) is the most common histological type of these rare tumours which may simply present with epistaxis or a blocked nose. A 79-year-old woman attended our clinic with a 2-year history of progressive nasal collapse resulting in a 'saddle nose deformity'. Imaging showed a soft tissue mass with absolute destruction of the nasal septum and bones with hard palate and maxillary involvement. Histology confirmed a poorly differentiated SCC. Following discussion at the local head and neck multidisciplinary team meeting, the patient was offered radiotherapy alone due to her advanced presentation. She has had a good response to treatment with no further disease progression. Nasal septal SCC is far more successfully treated in the early stages. A suspicious clinician is the patients best ally.

Intraparotid lymph node metastasis from a nasal septal carcinoma: an unusual source of the unknown primary

“…Nasal septal SCC is an exceedingly rare condition with only a few hundred cases reported in the literature. Patients typically present with nasal obstruction, epistaxis and nasal septal collapse resulting in saddle nose deformity 1–4. Metastasis to regional cervical lymph nodes is uncommon and thought to occur in less than 10% of patients at presentation 5…”