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Case Reports
. 2024 Sep 5;16(9):e68687.
doi: 10.7759/cureus.68687. eCollection 2024 Sep.

Sinonasal Squamous Cell Carcinoma Mimicking a Brain Abscess: Report of a Unique Case

Abhishek Patil  1 , Prem Durai  1 , Preeti Shetti  2 , Teena Desai  3 , Suprita Teli  2
Affiliations
Case Reports

Sinonasal Squamous Cell Carcinoma Mimicking a Brain Abscess: Report of a Unique Case

Abhishek Patil et al. Cureus. .

Abstract

Sinonasal cancers are rare tumors with squamous cell carcinoma (SCC) being one of the more common histological subtypes. These carcinomas typically invade the sinus cavity from which they originate, progressively eroding surrounding bony structures and extending to adjacent anatomical regions. In rare instances, they may breach the posterior or superior walls to invade the anterior cranial fossa (ACF) and frontal lobes. The normal flora of the nasal cavity and paranasal sinuses includes Staphylococcus aureus, Staphylococcus epidermidis, α- and γ-streptococci, Propionibacterium acnes, and aerobic diphtheroids. To our knowledge, cases of sinonasal malignancies extending into the frontal sinus and ACF, leading to a frontal lobe abscess caused by these organisms, have not been well-documented. We present a case of a 36-year-old male who underwent surgery for a right frontal brain abscess caused by Staphylococcus aureus. Histopathological analysis of the abscess wall revealed moderately differentiated SCC arising from the paranasal sinuses, highlighting a rare and intriguing presentation of this disease.

Keywords: frontal lobe abscess; paranasal sinuses; sinonasal cancer; squamous cell carcinoma; staphylococcus aureus.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Depicting pre-operative MRI brain (T1 images); isointense intra-axial space-occupying lesion in the right frontal lobe.
Figure 2
Figure 2. Depicting pre-operative MRI brain (T2 images); heterointense intra-axial space-occupying lesion in the right frontal lobe.
Figure 3
Figure 3. Depicting pre-operative contrast-enhanced T1 MRI images; ring enhancement pattern with extension into the right frontal and ethmoid sinuses.
Figure 4
Figure 4. Depicting the excised abscess wall.
Figure 5
Figure 5. Depicting the histopathological features of the excised wall; highly cellular and invasive epithelial neoplasm organized in sheets (hematoxylin and eosin stain).
Figure 6
Figure 6. Depicting immunohistochemical analysis; positive staining for pancytokeratin, focal positivity for cytokeratin-7, and negative staining for cytokeratin-20.
Figure 7
Figure 7. Depicting post-operative CT brain (plain); complete excision of the abscess wall and no operative site hematoma.
See this image and copyright information in PMC

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