Adenoid cystic carcinoma - sinonasal

Case contributed by Dr Victoria Aguilar Velasco

Presentation

Left maxillary tumor of one year of evolution. Clinically he presents anosmia, decreased visual acuity, and epistaxis.

Patient Data

Age: 60 years
Gender: Male

Initial CT

CT

CT An expansive lesion in the left maxillary sinus and invasion of the orbital floor, nasal cavity, sphenoid and ethmoid sinuses, and pharyngomucosal space. The lesion presents a solid-cystic component with heterogeneous enhancement as well as extensive bone destruction and conditions proptosis.

Initial MRI

MRI

MR left sinonasal expansive lesion, isointense on T1 and hyperintense on T2 with some hypointense areas, heterogeneous enhancement.

Post-operative CT

CT

CT surgical changes in the left maxillary sinus and residual lesion. Histopathological report adenoid cystic carcinoma

Case Discussion

Sinonasal adenoid cystic carcinoma is a rare malignancy characterized by perineural spread and intracranial extension.
The most common location is in the maxillary sinus, followed by the nasal cavity.
Symptoms of sinonasal include nasal obstruction, facial pain, epistaxis, runny nose, and anosmia.
Local recurrence and distant metastasis can occur decades after definitive treatment.

 

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