Abstract
BackgroundSmall cell neuroendocrine carcinoma (SNEC) of maxillary sinus is a rare and aggressive malignancy. A tumor with squamous cell carcinoma, adenocarcinoma and SNEC co-existence is extremely rare.Case presentationWe present a colliding tumor of squamous cell, adenocarcinoma and SNEC in maxillary sinus. The clinical features, diagnosis and EGFR flourescence in situ hybridization (FISH) study are presented. A 52-year-old female had a 1-month history of progressing left cheek swelling and purulent rhinorrhea. Magnetic resonance imaging showed a tumor involving left maxilla and orbital floor. Excision of tumor was done and the defect was reconstructed with free flap. The pathology revealed a malignant tumor composed of squamous cell carcinoma, adenocarcinoma and SNEC components. EGFR FISH study showed no gene amplification in 3 components of this tumor. The tumor progressed rapidly and the patient expired at 8 months after surgery.ConclusionA colliding tumor of squamous cell, adenocarcinoma and neuroendocrine carcinoma in maxillary sinus was aggressive in behavior and the treatment response was poor due to the complexity of tumor.
Highlights
A colliding tumor of squamous cell, adenocarcinoma and neuroendocrine carcinoma in maxillary sinus was aggressive in behavior and the treatment response was poor due to the complexity of tumor
Carcinoma of the paranasal sinuses accounts for about 0.3% of all cancers [1]
In a tumor of three different histologies and aggressive in behavior, we investigated the Epidermal growth factor receptor (EGFR) copy number by fluorescence in situ hybridization (FISH) in each component of the tumor
Summary
Most of the malignancies in paranasal sinus is squamous cell carcinoma (SCC) and followed by adenocarcinoma. Small cell neuroendocrine carcinoma (SNEC) is a rare tumor in head and neck region and it occurs most frequently in larynx [2]. The collision of three components (squamous cell, adenocarcinoma and neuroendocrine cells) in a solid tumor was very rare. In a tumor of three different histologies (squamous cell, adenocarcinoma and neuroendocrine cells) and aggressive in behavior, we investigated the EGFR copy number by fluorescence in situ hybridization (FISH) in each component of the tumor. Bony invasion was evident and the final pathology revealed a malignant tumor composed of SNEC, SCC and adenocarcinoma (Figure 2). The EGFR copy number was mostly monosomy in the ductal component, disomy in the neuroendocrine component and some trisomy in the squamous cell component (Figure 3).
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