Achour I, Chakroun A, Daoud J, Hammami B, Ghorbel A
Service d'ORL et chirurgie cervicofaciale, CHU Habib-Bourguiba, 3029 Sfax, Tunisie.
Service d'ORL et chirurgie cervicofaciale, CHU Habib-Bourguiba, 3029 Sfax, Tunisie.
Cancer Radiother. 2014 Nov;18(7):678-80. doi: 10.1016/j.canrad.2014.06.023. Epub 2014 Oct 3.
Low-grade sinonasal adenocarcinomas are uncommon and recently described entities. Its histologic diagnosis is challenging. This tumour is characterized by a tendency to local invasion, and rare distant metastases. Well treated, the prognosis is excellent. We describe a case of low-grade nasal cavity adenocarcinoma and discuss the anatomoclinical, therapeutic and evolutionary characteristics of this malignant tumour. A 54-year-old female patient presented with a 10 years history of right-sided nasal obstruction and recurrent epistaxis. On examination the patient had a large, firm mass in the right nasal cavity. Endoscopic sinonasal surgery was performed. The lesion was found to originate from the posteriolateral wall of the right nasal cavity. Histopathology analysis identified a low-grade sinonasal adenocarcinoma. Upon follow-up 4 years after surgery, the patient exhibited no clinical evidence of recurrence. Low-grade sinonasal adenocarcinomas are poorly defined neoplasms, accounting for 4 to 20% of all sinonasal malignancies. The nasal cavity is the most frequently involved site. Low-grade sinonasal adenocarcinomas pose a diagnostic challenge for the pathologist because they must be distinguished from benign tumours, especially adenomas. The primary treatment of sinonasal adenocarcinoma is complete surgical excision.
低级别鼻窦腺癌是罕见的且是最近才被描述的实体。其组织学诊断具有挑战性。该肿瘤的特点是有局部侵袭倾向,远处转移罕见。治疗得当,预后极佳。我们描述一例低级别鼻腔腺癌病例,并讨论这种恶性肿瘤的解剖临床、治疗及演变特征。一名54岁女性患者有10年右侧鼻塞和反复鼻出血病史。检查发现患者右侧鼻腔有一个大的、质地硬的肿块。进行了鼻内镜鼻窦手术。发现病变起源于右侧鼻腔后外侧壁。组织病理学分析确定为低级别鼻窦腺癌。术后4年随访,患者无复发的临床证据。低级别鼻窦腺癌是定义不明确的肿瘤,占所有鼻窦恶性肿瘤的4%至20%。鼻腔是最常受累的部位。低级别鼻窦腺癌给病理学家带来诊断挑战,因为它们必须与良性肿瘤,尤其是腺瘤相区分。鼻窦腺癌的主要治疗方法是完整手术切除。