509 Nasal SCC in a Young Caucasian Male

Abstract

IntroductionNasal squamous cell carcinoma (SCC) is common in Asian men in their 50s. However, 1 - 2 per million 15–19-year-old Caucasian patients will also develop nasal SCC. This case reports a rare finding of a 19-year-old Caucasian male with nasal SCC.MethodMedical records were used to access to all relevant clinical notes for the patient, including blood results, clinical documentation, imaging, and histology. The patient’s clinical journey was reviewed from initial referral to the ENT department to diagnosis with non-keratinising squamous cell carcinoma (NKSCC) stage IV b.Progression of disease: The patient was initially referred to ENT with unilateral tinnitus and temporal headache and diagnosed in clinic with glue ear and hypertrophic adenoidal tissue. He was due to have grommets and EUA, which was postponed due to the COVID-19 pandemic and lack of clinical suspicion of SCC. Patient was later seen in ED for epistaxis, and then for neck swelling after which he was diagnosed with SCC.ConclusionsAs the patient is a young, caucasian and a non-smoker, the initial diagnosis was lymphoma rather than SCC. This highlights the difficulties of diagnosing this type of cancer in young Caucasian patients.