title: Pre-operative chemoradiation for sinonasal undifferentiated carcinoma of the anterior nasal cavity resected through a lateral nasal flap approach.
abstract: BACKGROUND
  Sinonasal undifferentiated carcinoma (SNUC) is an exceedingly rare and aggressive tumor that carries a poor prognosis due to its non-specific presentation and advanced stage at time of diagnosis. Early detection and treatment are vital, with chemotherapy, radiation, and surgery all being viable options. The literature is sparse and there is no consensus for optimal treatment. In surgical candidates, the otolaryngologist must have a vast skill set in order to resect the tumor with wide margins and reconstruct the defect in hopes of returning the patient to their pre-morbid state.
  
  
  METHODS
  A 74-year-old female presented with a growing left nasal mass which was biopsied and found to be a sinonasal undifferentiated carcinoma originating from the anterior nasal cavity between the septum and upper lateral cartilage. The patient was treated with neo-adjuvant carboplatin with concurrent radiation, followed by resection through a lateral nasal flap. The defect was reconstructed with a contralateral septal hinge flap and septal cartilage graft with primary closure of the lateral nasal flap.
  
  
  RESULTS
  Intraoperatively, no skin or cartilage invasion was noted and as such, nasal skin was spared and utilized for primary closure. At a follow-up of 3 months, the patient had no evidence of recurrence and had a well healing repair site with satisfactory cosmesis.
  
  
  CONCLUSIONS
  Despite the aggressive nature of SNUC tumors, neo-adjuvant chemo-radiation and surgical intervention with functionally and aesthetically minded reconstruction can provide patients with improved outcomes and decreased morbidity.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, New York Medical College, Valhalla, NY, United States. Electronic address: B_surapaneni@nymc.edu.
authors.forename: Bhavishya
authors.initials: B
authors.lastname: Surapaneni
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States. Electronic address: skadakia@nyee.edu.
authors.forename: Sameep
authors.initials: S
authors.lastname: Kadakia
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States. Electronic address: olehslup@verizon.net.
authors.forename: Oleh
authors.initials: O
authors.lastname: Slupchynskyj
authors.affiliation: Department of Head and Neck Pathology, The New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States. Electronic address: ciacob@nyee.edu.
authors.forename: Codrin
authors.initials: C
authors.lastname: Iacob
authors.affiliation: Department of Head and Neck Radiology, The New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States. Electronic address: rholliday@nyee.edu.
authors.forename: Roy
authors.initials: R
authors.lastname: Holliday
mesh_terms: D000368:Aged; D001706:Biopsy; D002277:Carcinoma / Q000175:diagnosis / Q000628:therapy*; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008444:Maxillary Sinus Neoplasms / Q000175:diagnosis / Q000628:therapy*; D009296:Nasal Cavity / Q000528:radiation effects*; D014057:Tomography, X-Ray Computed