Adenoid cystic carcinoma involving paranasal sinus

Case contributed by Dr Varun Babu

Presentation

65 year old gentleman presented with watering from left eye since 5 months and swelling over left side of nose since 1 month.

Patient Data

Age: 65
Gender: Male
CT

CT paranasal sinuses

CT scan revealed a heterogeneously enhancing infiltrative lesion occupying the left maxillary sinus extending into the middle meatus. The lesion is eroding the walls of the sinus and breach is seen in the roof and floor of the maxillary sinus. However no evidence of any intra orbital or skull base extension was seen. 

Case Discussion

Clinical examination revealed a reddish mass in left middle meatus with left inferior turbinate slightly pushed medially. The mass was soft in consistency, smooth surface with no bony region underneath. 

Nasal endoscopy and biopsy was done. Histopathology report came positive for adenoid cystic carcinoma. 

Adenoid cystic carcinoma, that is , malignancy of minor salivary glands, most commonly affects the maxillary sinus among all the paranasal sinuses. It tends to recur locally with 'skip lesion' neural involvement. 

Wild local excision is key to management. 

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Case information

rID: 16580
Case created: 31st Jan 2012
Last edited: 2nd Oct 2015
System: Head & Neck
Inclusion in quiz mode: Included

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