Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Nov 20;16(11):e74066.
doi: 10.7759/cureus.74066. eCollection 2024 Nov.

Sinonasal Carcinoma With Aggressive Right Intraorbital Extension and Left Eye Invasion in a Young Female Patient

Nur Ain Shafiyah Mohd Ghazali  1 , Wan-Hazabbah Wan Hitam  1 , Nur Hafizah Maffar  1
Affiliations
Case Reports

Sinonasal Carcinoma With Aggressive Right Intraorbital Extension and Left Eye Invasion in a Young Female Patient

Nur Ain Shafiyah Mohd Ghazali et al. Cureus. .

Abstract

Sinonasal cancers are rare and aggressive head and neck malignancies. Sinonasal squamous cell carcinoma (SNSCC) typically affects males and individuals over the age of 55. Here, we present an unusual case of a young female diagnosed with SNSCC. She presented with painful right eye proptosis, rapid progressive vision loss in both eyes, and a history of intermittent epistaxis. MRI revealed an aggressive sinonasal mass with intra-orbital and intracranial extension, and a biopsy confirmed sinonasal non-keratinizing squamous cell carcinoma. Despite initial systemic chemotherapy, the patient discontinued treatment and, unfortunately, succumbed to the disease. This case highlights the aggressive nature and management challenges of advanced SNSCC, emphasizing the critical importance of early diagnosis and timely intervention to improve outcomes.

Keywords: bilateral intraorbital extension; intracranial extension; proptosis; sinonasal carcinoma; snscc.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent for treatment and open access publication 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. Contrast-enhanced computed tomography of the brain and paranasal sinus.
(A) Axial CT showed a large, heterogeneously enhancing lobulated solid mass occupying the right nasal cavity and paranasal sinuses. It extends into the medial aspect of the right intra- and extraconal fat spaces, causing right proptosis and lateral displacement of the right optic nerve (arrow). Poor fat plane of the right medial rectus muscle. (B) Coronal view revealed bony erosion of the nasal septum, right maxillary sinus walls, and both ethmoid air cells. A large mass (arrow) occupies the right nasal cavity extending into the right orbit and surrounding paranasal sinus. (C) Sagittal view showed an extension of the mass (arrow) into the sphenoid sinus and pituitary fossa with the erosion of the planum sphenoidale, sella turcica, and clivus.
Figure 2
Figure 2. Magnetic resonance imaging of the brain and orbit.
(A) Axial T2-weighted MRI showed a massive, well-defined, heterogeneous sinonasal mass extended into bilateral orbits, with greater right orbit involvement (arrow). (B) Coronal T2-weighted MRI showed the mass epi-centred at the right maxillary, sphenoid, ethmoid, and nasal cavity (asterisk). (C) Sagittal fluid-attenuated inversion recovery (FLAIR) MRI showed extension (arrow) of the sinonasal mass into the anterior cranial fossa.
Figure 3
Figure 3. Histopathology and immunohistochemistry assessment of the mass.
(A) The section demonstrates malignant epithelial cells arranged in sheets and nests, infiltrating the stroma (haematoxylin and eosin (H&E), 100x magnification). (B) The malignant epithelial cells display moderate pleomorphism, featuring round to enlarged nuclei, some with prominent nucleoli, and moderate pale to eosinophilic cytoplasm. Keratin pearls and intercellular bridges are absent (hematoxylin and eosin (H&E), 200x magnification). (C) The malignant epithelial cells are positive for CKAE1/AE3, epithelial marker (immunohistochemistry (IHC), 100x magnification). (D) The malignant epithelial cells exhibit nuclear positivity for p63, a squamous epithelial marker, as shown by immunohistochemistry (IHC) at 100x magnification.
Figure 4
Figure 4. Summary of the management of sinonasal carcinoma.
SNSCC = sinonasal squamous cell carcinoma; CT = computed tomography; MRI = magnetic resonance imaging
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Epidemiology of sinonasal squamous cell carcinoma: a comprehensive analysis of 4994 patients. Sanghvi S, Khan MN, Patel NR, Yeldandi S, Baredes S, Eloy JA. Laryngoscope. 2014;124:76–83. - PubMed
    1. Sinonasal carcinoma: clinical, pathological, genetic and therapeutic advances. Llorente JL, López F, Suárez C, Hermsen MA. Nat Rev Clin Oncol. 2014;11:460–472. - PubMed
    1. Prognostic factors and outcomes of de novo sinonasal squamous cell carcinoma: a systematic review and meta-analysis. Nguyen ES, Risbud A, Birkenbeuel JL, et al. Otolaryngol Head Neck Surg. 2022;166:434–443. - PubMed
    1. Squamous cell carcinoma and its variants. Mani N, Shah JP. Adv Otorhinolaryngol. 2020;84:124–136. - PubMed
    1. A review of surgical outcomes of management of sinonasal malignancies: a 8-year of clinical experience (2013-2021) at the tertiary centre, Sarawak. Yee LW, Jumastapha H, Tang CL, Tang IP. Indian J Otolaryngol Head Neck Surg. 2024;76:5833–5838. - PMC - PubMed

Publication types

LinkOut - more resources