Microscopic Residual Disease After Nasal Squamous Cell Carcinoma Not Visualized on FDG PET-CT: A Case Report

Nasal squamous cell carcinoma (SCC) is rare and aggressive. It often requires combination treatment. Precise post-treatment disease assessment is vital for determining the subsequent management and prognosis. We present the intriguing case of a 52-year-old man with T4bN0M0 stage IVB SCC. Post-treatment fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) findings indicated a complete response; however, microscopic remnants of the cancer were detected during endoscopic sinus surgery. This report underscores the limitations of post-treatment assessment using FDG PET-CT and outpatient endoscopy alone due to these modalities' potential inability to detect microscopic residual disease. Endoscopic sinus surgery should be incorporated into routine post-treatment assessments of nasal SCC to improve disease detection and guide further treatment. Further large-scale studies are required to confirm these findings.