Sinonasal carcinoma presenting as chronic sinusitis and sequential bilateral visual loss

Area of Science:

• Ophthalmology
• Otolaryngology
• Oncology

Background:

• Sinonasal undifferentiated carcinoma (SNUC) is a rare malignancy.
• SNUC can lead to rhinogenic optic neuropathy, causing vision loss.
• Bilateral sequential visual loss from this cause is exceptionally rare.

Observation:

• This case report details the first instance of bilateral sequential visual loss attributed to SNUC-related rhinogenic optic neuropathy.
• The patient experienced progressive vision impairment.
• Magnetic resonance imaging (MRI) findings were crucial for differentiating malignancy from chronic sinusitis.

Findings:

• The study highlights the diagnostic challenge in distinguishing SNUC from inflammatory sinonasal conditions.
• Despite multidisciplinary treatment including surgical decompression, steroids, chemotherapy, and radiotherapy, no visual improvement was observed.
• This suggests a rapid disease progression in this specific case.

Implications:

• Early and accurate diagnosis of SNUC is critical for potentially preserving vision.
• Multidisciplinary management is essential for patients with SNUC-induced optic neuropathy.
• The lack of visual improvement underscores the aggressive nature of the disease and the need for prompt intervention.