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Tumor Discovery

CASE REPORT
High-grade sinonasal adenocarcinoma as an

unusual presentation: A case report

Sara Moujrid*, Fadoua El Mourabit, Walid Bijou, Youssef Oukessou,
Sami Rouadi, Reda Abada, Mohamed Roubal, and Mohamed Mahtar
Department of ENT Head and Neck Surgery, Ibn Rochd University Hospital, Faculty of Medicine and
Pharmacy, Hassan II University, Casablanca, Morocco

Abstract

The occurrence of malignant tumors, such as adenocarcinoma, is commonplace in the
nasal region, characterized by a notably low incidence. This rarity often contributes to
delayed diagnosis, rendering the condition challenging to manage. Here, we present
the case of a 70-year-old man who presented with chronic left nasal obstruction,
accompanied by headaches and recurrent epistaxis. The diagnostic investigation
revealed an extensive and aggressive nasal adenocarcinoma, necessitating a hemi-
maxillectomy for tumor excision. Subsequent reconstruction of the ipsilateral cheek
was accomplished using a pectoralis major flap. Despite the initial intervention, the
patient experienced a recurrence 1 year later. In sinonasal adenocarcinoma, nasal
obstruction stands out as the predominant symptom, complemented by potential
manifestations of swelling and facial deformation. The inherently aggressive
nature of this tumor underscores the imperative for early diagnosis and meticulous
management to achieve optimal therapeutic outcomes. The comprehensive
approach involving surgical intervention and reconstruction reflects the complexity
*Corresponding author: in treating advanced nasal adenocarcinomas.
Sara Moujrid
(saramoujrid9@gmail.com)
Keywords: Adenocarcinoma; Malignancy; Nose; Paranasal sinuses
Citation: Moujrid S, El Mourabit F,
Bijou W, et al. High-grade sinonasal
adenocarcinoma as an unusual
presentation: A case report. Tumor
Discov. 2024;3(2):2423. 1. Introduction
doi: 10.36922/td.2423
Received: December 13, 2023 Primary sinonasal adenocarcinomas are rare tumors exhibiting a broad morphological
spectrum. They are generally divided into two groups: intestinal-type sinonasal
Accepted: March 28, 2024 adenocarcinoma (ITAC) and non-ITAC subtypes. These neoplasms are estimated to
1
Published Online: May 30, 2024 constitute merely 13% of all documented cases of sinonasal carcinoma. 2,3
Copyright: © 2024 Author(s). The classification of adenocarcinoma holds paramount significance as it not only
This is an Open-Access article dictates the tumor’s behavior but also predicts the patient’s prognosis. Observational
distributed under the terms of the
Creative Commons Attribution data indicate that individuals afflicted with low-grade adenocarcinomas typically endure
License, permitting distribution, prolonged symptoms, experience reduced pain, and are less prone to deformities.
and reproduction in any medium, Conversely, high-grade lesions entail more extensive involvement of the paranasal
provided the original work is
properly cited. sinuses, signifying heightened invasiveness. 4
Publisher’s Note: AccScience The primary objective of implementing surgery is to completely remove the lesion
Publishing remains neutral with to ensure a favorable outcome. While various external approaches can be employed,
regard to jurisdictional claims in
published maps and institutional endoscopic surgery has gained prominence in recent years. This shift is attributed to
affiliations. its comparable clinical outcomes, lower incidence of complications, and diminished

Volume 3 Issue 2 (2024) 1 doi: 10.36922/td.2423