Adenocarcinoma Nasossinusal- a Relevância da História Ocupacional

Abstract

Introduction Nasosinusal Adenocarcinomas are rare neoplasms that account for less than 5% of head and neck cancers. Occupational risk factors that have been linked to a higher incidence of Nasosinusal Adenocarcinomas include chronic exposure to wood dust and/or leather, nickel and chromium compounds, formaldehyde and other solvents, and polycyclic aromatic hydrocarbons. Occupations with exposure to dense wood dust are particularly associated with the intestinal subtype of adenocarcinoma, the most frequent location of which occurs in the ethmoid sinus and upper nasal cavity. The report of this clinical case aims to raise awareness among health professionals for the surveillance and early diagnosis of these occupational cancers. Description of the Clinical Case The authors present the case of an 81-year-old man who worked for 56 years as a joiner in the furniture industry. In his occupational history he denied the use of Personal Protective Equipment, namely respiratory protection. In a surveillance consultation with his family physician, he reported epistaxis and occasional nasal obstruction of the right nostril with an evolution of about three months. During the evaluation, a neoformative lesion was diagnosed in the right nasal fossa and the patient was immediately referred to Otorhinolaryngology consultation. A biopsy of the lesion revealed “morphological aspects of intestinal adenocarcinoma”. After evaluation in group consultation, he was proposed for endoscopic sinus surgery and adjuvant radiotherapy. Discussion/Conclusion Occupational exposure to wood dust should lower the physician’s threshold of suspicion for symptoms suggestive of occupational cancer. The long latency period for the development of adenocarcinoma and the higher survival of people treated in the early stages of the disease make periodic medical surveillance in the early detection of nasal adenocarcinoma necessary. Keywords: Nasosinusal Adenocarcinoma, Wood Dust, Occupational Disease, Ocupational Medicine, General and Family Medicine.