J Rhinol.  2017 May;24(1):56-59. 10.18787/jr.2017.24.1.56.

A Case of the Low-Grade, Non-Intestinal type Sinonasal Adenocarcinoma of Nasal Septum

• Shin JH
• Kwak KH
• Lee JG
• Kim TH

• KMID: 2379792
• DOI: http://doi.org/10.18787/jr.2017.24.1.56

Abstract

Adenocarcinomas of the sinonasal tract are relatively rare. Such tumors are divided into salivary and nonsalivary types as classified by the World Health Organization. Nonsalivary sinonasal adenocarcinomas are further classified as intestinal (ITAC) and non-intestinal (non-ITAC), which can be separated even further into high-grade and low-grade. Low grade non-ITACs are more uncommon than ITACs. In this study, we present a case of low-grade non-ITAC in a 61-year-old woman who was successfully treated with wide excision without radiotherapy, and we also provide a review of the literature.

Keyword

Adenocarcinoma; Nasal septum; Nasal cavity

MeSH Terms

Adenocarcinoma*
Female
Humans
Middle Aged
Nasal Cavity
Nasal Septum*
Radiotherapy
World Health Organization

Figure

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  Fig. 1. Endoscopic finding demonstrates polypoid mass between left middle turbinate and septum ( S: septum, M: middle turbinate, arrow: mass).

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  Fig. 2. Contrast-enhanced comput-ed tomography scans show heterogeneously enhancing soft tissue mass occupying both nasal cavities and nasopharynx. Tumor invasion into nasal septum and nasopharynx is suspicious, and soft tissue density in the left sphenoid sinus is observed. ( A) Axial, ( B) Coronal.

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  Fig. 3. ( A) Complex glandular growth pattern lacking an intervening fibro-vascular stroma demonstrated by hematoxylin and erosion ( H&E) stain-ing (×40). ( B) Single layer of noncil-liated columnar cells with uniform, round nuclei identified by H&E stain-ing (×100).

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  Fig. 4. ( A) Coronal T1 weighted magnetic resonance imaging ( MRI) shows the low signal intensity mass in the left nasal cavity. ( B) Axial Gadolinium-enhanced T1 weighted MRI demonstrates heterogeneously enhancing mass in the both nasal cavities and nasopharynx without invasion of nasal septum and nasopharynx. ( C) Axial T2 weighted MRI reveals the high signal intensity mass, too.

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  Fig. 5. ( A) Postoperative endoscopic finding, ( B) CT, and ( C) T2 weighted MRI show no evidence of recurrence ( S: septum, O: sphenoid ostium, T: superior turbinate).

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