Maxillary sinus carcinoma: the only symptom was neck lymph node swelling

Area of Science:

• Oncology
• Radiology
• Head and Neck Surgery

Background:

• Maxillary sinus carcinoma typically presents with local symptoms due to bone structure involvement, such as cheek pain and nasal obstruction.
• Cervical lymph node metastasis is considered less common in maxillary sinus carcinoma.

Observation:

• A rare case of undifferentiated carcinoma in the right maxillary sinus is presented in a female patient.
• The primary symptom was cervical swelling, indicative of lymph node metastasis, with minimal initial findings on CT and MRI.

Findings:

• Fluorine 18-labelled deoxyglucose positron emission tomography (FDG-PET) proved crucial for identifying the primary tumor site, which was obscured by apparent maxillary sinusitis and minor bone destruction on conventional imaging.
• The patient achieved a complete response to concomitant chemoradiotherapy for both the primary tumor and metastatic neck lymph nodes.
• No recurrence was observed for 18 months post-treatment.

Implications:

• This case highlights the importance of advanced imaging techniques like FDG-PET in diagnosing atypical presentations of maxillary sinus carcinoma.
• Early and accurate diagnosis through advanced techniques can lead to effective treatment and improved outcomes for patients with rare or asymptomatic presentations.
• The findings suggest that FDG-PET can be a valuable tool for detecting primary sites in cases where conventional imaging is inconclusive.