Hypofractionated palliative radiotherapy for advanced ethmoid sinus squamous cell carcinoma: a case report

Ethmoid sinus cancer is a rare malignancy, that is, often diagnosed at an advanced stage, making surgical intervention challenging. Herein, we report a case of advanced ethmoid sinus squamous cell carcinoma in a female patient in her 90s. The patient presented with right-sided proptosis, ptosis, diplopia, and nasal obstruction. She was considered unfit for radical surgery or chemoradiotherapy because of her age and other comorbidities. She underwent hypofractionated palliative radiotherapy (35 Gy in 5 fractions) targeting the clinical tumor volume only. Clinically meaningful symptom relief and substantial tumor shrinkage were observed post-treatment, with minimal acute toxicities, although conclusions regarding treatment efficacy should be interpreted cautiously given the single-patient nature of this report. This case illustrates the potential of hypofractionated radiotherapy as a palliative option for patients deemed unsuitable for radical treatments.