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Case Reports
. 2015 Dec 21;7(12):e421.
doi: 10.7759/cureus.421.

Basaloid Squamous Cell Carcinoma of the Ethmoid Sinus with Invasion into the Skull Base Treated with Craniofacial Resection and Adjuvant Intensity-Modulated Radiation Therapy: A Case Report

Karine A Al Feghali  1 , Henri Traboulsi  2 , Bassem Youssef  1
Affiliations
Case Reports

Basaloid Squamous Cell Carcinoma of the Ethmoid Sinus with Invasion into the Skull Base Treated with Craniofacial Resection and Adjuvant Intensity-Modulated Radiation Therapy: A Case Report

Karine A Al Feghali et al. Cureus. .

Abstract

Basaloid squamous cell carcinoma (BSCC) is a rare variant of squamous cell carcinoma (SCC), which is highly aggressive, with a tendency for multifocality, local invasion, and with a high metastatic potential. Less than forty cases of BSCC of the sinonasal tract have been reported in the literature, and no reports were found on sinonasal BSCC arising from the ethmoid sinus. We report the case of a 78-year-old man who presented with BSCC arising from the ethmoid sinus with extensive bone destruction and intracranial extension. He was treated with craniofacial resection followed by adjuvant intensity-modulated radiation therapy to the tumor bed (60 Gy in 30 fractions), and the upper neck lymph nodes (50 Gy in 25 fractions). At the patient's last follow-up, four months after diagnosis, there was no evidence of disease. Aggressive management using craniofacial resection followed by adjuvant radiation therapy with or without radiosensitizing chemotherapy seems to be a reasonable approach to this challenging disease.

Keywords: basaloid squamous cell carcinoma; ethmoid sinus; intensity modulated radiation therapy; sinonasal tumors.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Contrast-enhanced computed tomography scan
Coronal cut showing the lesion eroding the bilateral lamina papyracea and the cribriform plate and encroaching on the medial recti muscles.
Figure 2
Figure 2. Contrast-enhanced computed tomography scan
Sagittal cut showing the lesion involving the ethmoid sinuses, invading the nasal cavity and septum, the frontal and sphenoid sinuses, with base of skull erosion and intracranial extension.
Figure 3
Figure 3. Contrast-enhanced computed tomography scan
Axial cut showing the lesion extending into the left sphenoid sinus, involving the cavernous sinus and engulfing the left internal carotid artery.
Figure 4
Figure 4. Intensity-modulated radiation therapy plan
Axial cut showing the isodose lines curving around the optic nerves. The tumor bed was treated to 60 Gy in 30 fractions.
See this image and copyright information in PMC

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