Recurrent adenocarcinoma of the sinonasal tract.
BACKGROUND
Adenocarcinomas arising from the nasal cavity and paranasal sinus are malignant tumours that are not of minor salivary gland origin, and they do not demonstrate histopathological features of sinonasal intestinal-type adenocarcinoma. These adenocarcinomas are divided into low- and high-grade subtypes. We herein present a case to highlight the significance of a correct histological diagnosis for treatment and follow-up.


METHODS
We report a case of a recurrent low-grade adenocarcinoma arising in the left nasal cavity and extending to the ethmoid, maxillary sinus and orbital floor. No facial deformity or proptosis was present. The diagnosis was made by analysis of a sample taken by biopsy and CT-MRI. We performed a radical maxillectomy and reconstruction with a temporalis muscle flap and a titanium mesh for the orbital floor.


CONCLUSIONS
Low-grade adenocarcinomas of the sinonasal tract are a challenge for the pathologist to differentiate from benign adenomas and high-grade adenocarcinomas, but the distinction is important because the treatment and prognosis differ. Treatment success is determined by complete surgical excision. We also suggest the usefulness of PET to detect recurrence during follow-up.
Oral and Maxillofacial Department, Hospital Universitario Santa Lucia, C/.Mezquita-Paraje Los Arcos, Cartagena, Murcia, Spain. ravipuc@hotmail.com
Raquel
R
Villar
Benito
B
Ramos
Manuel
M
Acosta
Juan Jose
JJ
Haro
Antonio
A
Gómez
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008437:Maxilla / Q000601:surgery; D009296:Nasal Cavity / Q000473:pathology / Q000601:surgery; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D009669:Nose Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010255:Paranasal Sinus Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010256:Paranasal Sinuses / Q000473:pathology / Q000601:surgery; D012086:Reoperation / Q000379:methods; D013524:Surgical Flaps / Q000601:surgery; D013526:Surgical Mesh; D014057:Tomography, X-Ray Computed; D014420:Turbinates / Q000473:pathology / Q000601:surgery