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. 2018 Sep;19(3):210-213.
doi: 10.7181/acfs.2018.01970. Epub 2018 Sep 20.

Sinonasal intestinal-type adenocarcinoma in the frontal sinus

Jaewoo Kim  1 , Hak Chang  1 , Euicheol C Jeong  2
Affiliations

Sinonasal intestinal-type adenocarcinoma in the frontal sinus

Jaewoo Kim et al. Arch Craniofac Surg. 2018 Sep.

Abstract

Sinonasal intestinal-type adenocarcinoma is a rare neoplasm which can be diagnosed by pathologic report. Nasal obstruction, epistaxis, and rhinorrhea are common symptoms, but presenting with a benign-looking palpable mass is also possible. This is a report of our experience in diagnosing and treating a sinonasal intestinal-type low grade adenocarcinoma. A 63-year-old man initially presented with a rapidly growing palpable mass in the glabella region for 4 months. A malignancy of sinus origin was suspected on imaging studies. We performed further preoperative evaluations for cancer staging, and curative surgery was planned. Radical resection and immediate reconstruction with free anterolateral thigh flap were performed. The pathology findings confirmed a diagnosis of sinonasal intestinal-type adenocarcinoma.

Keywords: Adenocarcinoma; Intestinal; Neoplasm; Sinonasal; Sinus.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
A 63-year-old man with a painless soft mass on his glabellar region.
Fig. 2.
Fig. 2.
Contrast computed tomography. A 3.1×2.6×2.0 cm soft tissue mass at the right fronto-ethmoidal sinus destructing the outer table of the frontal sinus wall.
Fig. 3.
Fig. 3.
Magnetic resonance imaging. Soft tissue enhancing mass at the right frontal sinus with extrusion through the right frontal sinus anterior wall. Suspicious extension to the left forehead and extension to the right ethmoid sinus and upper nasal soft tissue area was observed.
Fig. 4.
Fig. 4.
Open biopsy gross photograph. Sinonasal intestinal-type adenocarcinoma (mass #1 and #2).
Fig. 5.
Fig. 5.
Histopathologic finding. Sinonasal intestinal-type adenocarcinoma in the frontal sinus (H&E, ×100). The arrows point some tumor cell invasion findings which are critical to diagnose malignancy.
Fig. 6.
Fig. 6.
Intraoperative photograph. Wide excision with removal of the frontal sinus posterior wall mucosa before immediate reconstruction.
Fig. 7.
Fig. 7.
Immunohistochemical staining. Sinonasal adenocarcinoma, favoring low-grade. Ki-67 positive, nearly 90% (×200). The arrows point some stained cells which are Ki-67 positive.
Fig. 8.
Fig. 8.
Postoperative follow-up photograph at the outpatient clinic after 76 days.
See this image and copyright information in PMC

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