Sinonasal Neuroendocrine Carcinoma: A Case report

Area of Science:

• Oncology
• Otorhinolaryngology
• Pathology

Background:

• Neuroendocrine carcinomas are rare tumors originating from specialized neuroendocrine cells, with common sites including the lungs, gastrointestinal tract, and pancreas.
• Sinonasal neuroendocrine carcinoma is an exceptionally rare presentation of this malignancy.
• This report focuses on a unique case within the sinonasal region.

Purpose of the Study:

• To report a rare case of sinonasal neuroendocrine carcinoma.
• To describe the clinical presentation, diagnostic workup, and management of this rare tumor.
• To highlight the treatment outcomes and follow-up of a patient with this condition.

Main Methods:

• A case study of a 65-year-old female patient presenting with sinonasal symptoms.
• Clinical examination, computed tomography (CT) scans, and endoscopic tumor removal were performed.
• Histopathological examination with immunohistochemistry confirmed the diagnosis of small cell neuroendocrine carcinoma.
• Postoperative external radiation therapy was administered.

Main Results:

• The patient presented with right nasal obstruction, bloody discharge, and epistaxis.
• Imaging revealed an enhancing, expansile, necrotic mass in the right nasal cavity with associated mucosal thickening in the sinuses.
• Biopsy and immunohistochemistry confirmed poorly differentiated small cell neuroendocrine carcinoma.
• The patient received 6600 cGy radiation over 33 fractions postoperatively.
• Endoscopic follow-up for 12 months showed no evidence of local tumor recurrence.

Conclusions:

• Sinonasal neuroendocrine carcinoma, though rare, should be considered in the differential diagnosis of sinonasal masses.
• Multidisciplinary management involving endoscopic surgery and adjuvant radiation therapy can be effective.
• Long-term surveillance is crucial for detecting potential recurrence in these rare malignancies.