Sinonasal Undifferentiated Carcinoma of Nasal Cavity: A Case Report

Abstract

Sinonasal undifferentiated carcinoma (SNUC) is a rare and highly aggressive cancer of paranasal sinuses (PNS) and superior nasal cavity. Due to the rarity and highly aggressive nature of the tumor, there is a lack of consensus regarding optimal treatment in these patients. This reported a case of a 38-year-old man who presented with difficult breathing. The disease was diagnosed as a locally advanced SNUC involving the ethmoid and maxillary sinuses by tissue diagnosis, confirmed by immunohistochemistry. The staging was B by Kadish system. The multiple modality approach should result in the best possible outcome in this patient. He was treated with endoscopic medial maxillectomy followed by chemoradiation with a course of 70 Gray (Gy) in 35 fractions delivered combination with weekly cisplatin regimen for chemotherapy. Nine months after treatment completion, he developed a metastasis at the thoracic spines, ribs and pubic bone and femur. A five-fraction palliative radiotherapy of 20 Gy was delivered to pelvis and the left femur. He survived 22 months from the initial presentation. This is the first reported case of a SNUC patient at Udon Thani Cancer Hospital. Although the treatment can only be based on reported case series and a small number of retrospective studies, consequently it is crucial to continue to assess different institutions’ methods and results of treatment.