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Updated: May 21, 2026
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
A massive adenoid cystic carcinoma of nasal septum progressed into the skull base
Kosuke Akiyama1, Masayuki Karaki, Hiroshi Hosikawa
1Department of Otolaryngology, Faculty of Medicine, Kagawa University, Kagawa, Japan. kakaka@med.kagawa-u.ac.jp
Background:
Adenoid cystic carcinoma (ACC) is a malignant tumor commonly occurring in the major salivary glands. ACC of the nasal septum is exceeding rare.
Methods:
The case of a 42-year-old woman with ACC of the nasal septum is presented. Her chief complaint was nasal obstruction and dysosmia for two month. CT and MRI demonstrated a massive mass occupying the nasal septum infiltrating the palate, vomeronasal, anterior skull base, and dura mater. Combined anterior cranial surgery, endoscopic intranasal surgery, and transpalatal surgery were selected due to the size and location of the tumor. A negative surgical margin was achieved without cosmetic deformity or functional disorder.
Results:
She had postoperative radiotherapy with no recurrence or distant metastasis during the follow-up period.
Conclusion:
The tumor location and the perineural spread pattern should be considered to determine the treatment plan for septum ACC. Post operative radiation is now generally recommended. ACC has a high incidence of local recurrence and distant metastasis rate; therefore, long-term follow-up is necessary.
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