Chu Samuel, Husain Salina
Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Ampang, Ampang, MYS.
Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS.
Cureus. 2024 Aug 26;16(8):e67878. doi: 10.7759/cureus.67878. eCollection 2024 Aug.
Adenocarcinoma of the frontal sinus is extremely rare. We present a primary frontal sinus adenocarcinoma masquerading as an inverted papilloma (IP). Here, we reviewed various clinical presentations, investigations, and management of frontal sinus adenocarcinoma. A 48-year-old male presented with nasal bridge swelling one month following endoscopic sinus surgery for frontal sinus inverted papilloma. Progressively enlarging swelling with persistent pressure symptoms drew doubts regarding previously proven diagnosis. Imaging studies put us at the management crossroads of malignancy versus infection (osteomyelitis). The complexity of this case prompted a multidisciplinary team approach, eventually leading to a revision surgery for re-evaluation. Re-excision of the frontal sinus tumor was later proven to be adenocarcinoma of the frontal sinus. This case underscores the importance of thorough follow-up and investigation in patients presenting with recurrent or persistent symptoms following sinus surgery. This case highlighted the need for a high index of suspicion and comprehensive diagnostic workup.
额窦腺癌极为罕见。我们报告了一例伪装成内翻性乳头状瘤（IP）的原发性额窦腺癌。在此，我们回顾了额窦腺癌的各种临床表现、检查及治疗方法。一名48岁男性在因额窦内翻性乳头状瘤接受鼻内镜鼻窦手术后1个月出现鼻梁肿胀。肿胀逐渐增大并伴有持续的压迫症状，这使人们对先前确诊的诊断产生怀疑。影像学检查让我们处于恶性肿瘤与感染（骨髓炎）的治疗抉择关头。该病例的复杂性促使采用多学科团队方法，最终导致进行再次手术以重新评估。后来再次切除额窦肿瘤被证实为额窦腺癌。该病例强调了对鼻窦手术后出现复发或持续症状的患者进行全面随访和检查的重要性。此病例突出了高度怀疑指数和全面诊断检查的必要性。
