Aggressive verrucous carcinoma of the paranasal sinuses invading the orbit: case report and literature review.
BACKGROUND
Verrucous carcinoma is a variant of well differentiated squamous cell carcinoma characterised by an exophytic, warty growth which is slowly but locally invasive and which can cause extensive local destruction if left untreated.


METHODS
We report the first known case of veruccous carcinoma of the paranasal sinuses with rapid orbital invasion. A 58-year-old man presented with right-sided nasal obstruction, a huge right intranasal lesion, intractable dacryocystitis and cutaneous involvement of the nasolacrimal sac region. The tumour was partially removed using an endoscopic transnasal approach. Post-operatively, and while waiting for the histological result, the patient developed signs of rapid invasion of the orbit, with uniocular visual acuity deficit. He underwent combined radiochemotherapy, with a moderate response.


CONCLUSIONS
Knowledge of the potentially aggressive nature of verrucous carcinoma may be helpful in early management of intraorbital invasion and salvaging of the eye.
Yiotakis
J
J
Otorhinolaryngology Department, Athens University, Ippokration General Hospital, Greece.
Vamvakidis
T
T
Iakovou
E
E
Manolopoulos
L
L
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018289:Carcinoma, Verrucous / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D018450:Disease Progression; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009918:Orbital Neoplasms / Q000473:pathology* / Q000628:therapy; D010256:Paranasal Sinuses / Q000473:pathology*; D018714:Radiotherapy, Adjuvant; D016896:Treatment Outcome