A Case of Sinonasal Adenoid Cystic Carcinoma Presenting as a Huge Nasal Polyp

Abstract

Received September 12, 2012 Revised October 9, 2012 Accepted October 9, 2012 Address for correspondence Jeong Hong Kim, MD Department of OtorhinolaryngologyHead and Neck Surgery, Jeju National University College of Medicine, Aran 13-gil, Jeju 690-767, Korea Tel +82-64-717-1716 Fax +82-64-717-1029 E-mail sevent70@hanmail.net Adenoid cystic carcinoma (ACC) is the second most common malignancy in sinonasal tract occurring in the minor salivary gland of paranasal sinuses. It is also an aggressive neoplasm that results in a high incidence of both local recurrence and distant metastasis by perineural invasion. A 67-year-old woman had developed progressive nasal obstruction and facial pain for over two years. The imaging study showed a huge polypoid mass in the paranasal sinuses bulging into the nasal cavity without any adjacent bony erosion and orbital extension. The pathology was reported as a cribriform type of ACC. The mass was removed by endonasal endoscopic surgery and “Mini” Caldwell-Luc operation. Considering local recurrence due to perineural lymphatic invasion, postoperative radiation therapy was performed. We discuss here how the combination of endonasal endoscopic surgery and radiotherapy could provide the best chance for disease control in the selected stages of ACC. Korean J Otorhinolaryngol-Head Neck Surg 2012;55:798-801 Key WordsZZAdenoid cystic carcinoma ᆞSinonasal tract.