Gurung Shekhar, Pathak Bishnu Deep, Karki Saurab, Khadka Manoj, Parajuli Ganesh
Aaruchanaute Primary Health Care Center, Arughat-9, Gorkha, Nepal.
Shree Birendra Hospital, Chhauni, Kathmandu, Nepal.
Int J Surg Case Rep. 2022 May;94:107055. doi: 10.1016/j.ijscr.2022.107055. Epub 2022 Apr 7.
Adenoid cystic carcinoma rarely involves the nose and paranasal sinuses. It is a slowly growing, aggressive malignant tumor with a predisposition for perineural invasion. The study highlights the importance of timely diagnosis and management of adenoid cystic carcinoma.
Herein, we report a case of adenoid cystic carcinoma of maxillary antrum in a 69 years old female, who presented with an insidious onset of painful right cheek swelling for three months. Biopsy showed the glandular pattern of tumor cells with perineural invasion, suggestive of adenoid cystic carcinoma. Contrast-enhanced computed tomography of paranasal sinuses showed a well-differentiated, irregularly outlined, non-enhancing heterogeneous lesion in the right maxillary sinus with bony destruction, suggesting the malignant nature of the lesion. The mass was surgically excised and histopathological examination further confirmed the diagnosis.
Adenoid cystic carcinoma is a rare malignancy of the nose and paranasal sinus, although it is quite common in salivary glands. It should be considered in the differentials in a patient presenting with sinonasal mass, pain, nasal obstruction, epistaxis, and auditory symptoms.
As the tumor can be missed clinically owing to its rarity in paranasal sinuses and can present at an advanced stage, early diagnosis and management of adenoid cystic carcinoma are important.
腺样囊性癌很少累及鼻腔和鼻窦。它是一种生长缓慢、侵袭性强的恶性肿瘤，易发生神经周围浸润。本研究强调了腺样囊性癌及时诊断和治疗的重要性。
在此，我们报告一例69岁女性上颌窦腺样囊性癌病例，患者右侧面颊部隐匿性疼痛肿胀3个月。活检显示肿瘤细胞呈腺管样结构并伴有神经周围浸润，提示腺样囊性癌。鼻窦增强计算机断层扫描显示右侧上颌窦有一个分化良好、轮廓不规则、无强化的不均匀病变，伴有骨质破坏，提示病变具有恶性特征。该肿物经手术切除，组织病理学检查进一步确诊。
腺样囊性癌是鼻腔和鼻窦罕见的恶性肿瘤，尽管在涎腺中较为常见。对于出现鼻窦肿物、疼痛、鼻塞、鼻出血及听觉症状的患者，鉴别诊断时应考虑到该病。
由于该肿瘤在鼻窦中罕见，临床上可能漏诊，且可能在晚期才出现症状，因此腺样囊性癌的早期诊断和治疗很重要。
