Endocrine-amphicrine enteric carcinoma of the nasal mucosa

A 39-year-old bus driver had been suffering for 2 years from a malignant polypoid mucosal proliferation of the upper nasal concha-ethmoid region, resembling a highly differentiated, villous-glandular adenocarcinoma of enteric type. There were numerous mono- and amphicrine cells and a massive quantity of oxyphilic, frequently Paneth-like goblet cells in the tumor. Immune-histochemically, a number of gastrin- and fewer glucagon-positive cells were identified. The somatostatin level in the serum was clearly increased. Electron-microscopically, 7 different endocrine cell types were identifiable, in order of decreasing frequency: A-like- and G-cells, both types of 5-HT-cells, A-cells, EG- and K-cell-like elements. Particularly impressive were the muco-argyrophilic amphicrine cells, containing A-granules. The unusual enteric character of the carcinoma seems to result from boundary movements and tissue displacements in an ecto-entodermal embryonic border region. There was no history of occupational wood dust inhalation.