Adenoid cystic carcinoma of the nasal cavityâ€”the great mimicker of chronic rhinitis: A rare case report with literature review

James Yahaya,Zephania Abraham

doi:10.5348/100067z06jy2019cr

Abstract

Introduction: Adenoid cystic carcinoma (ACC) of the nasal cavity is one of the rarest malignant entities reported in the literature with the known incidence of up to 5%. It commonly poses a diagnostic challenge due to lack of diagnostic suspicion index because of its rarity and especially when it is associated with a long history of benignity. Adenoid cystic carcinoma is a tumor of salivary glands even though it is not frequent. Moreover, it can rarely occur in other body parts, such as nose, paranasal sinuses, lungs, uterine cervix, and many others. Case Report: We present a case of an 18-year-old boy with a diagnosis of ACC of the nasal cavity. The patient had a 10-year history of long-standing chronic inflammatory condition presenting as rhinitis. However, after a period of two years later following the initial diagnosis, the tumor became aggressive and it presented with ulceration, causing erosion of the nasal bone as well as auto-exenteration of the right eye. Conclusion: Adenoid cystic carcinoma involving the nose and other paranasal sites ought to be deemed as a tumor with sometimes long-standing history of benignity which needs high index of suspicion for being able to detect it in order to improve outcome of the patients.

Highlights

Adenoid cystic carcinoma (ACC) of the nasal cavity is one of the rarest malignant entities reported in the literature with the known incidence of up to 5%
When ACC involves the paranasal sinuses, the maxillary sinus is the most common site followed by the nasal cavity especially the lateral wall, as reported in most of the literatures [4]
ACC arises from pseudostratified columnar epithelium rather than the glandular tissue of salivary glands [4]

Summary

INTRODUCTION

Adenoid cystic carcinoma (ACC) accounts for approximately 10% of salivary gland tumors [1, 2]. When ACC involves the paranasal sinuses, the maxillary sinus is the most common site followed by the nasal cavity especially the lateral wall, as reported in most of the literatures [4] For this reason, ACC arises from pseudostratified columnar epithelium rather than the glandular tissue of salivary glands [4]. The swelling was progressively increasing in size and later on it started ulcerating and it was extending to involve other parts of the nose, face, and the right eye (Figure 1) This was followed by nasal blockage, copious purulent nasal discharge mixed with blood for some time. He went back home in the village and he did not make any followup for a period of about two years He developed hemiplegia due to paralysis of both lower limbs, episodes of severe headache mainly in the frontal side of the head and auto-exenteration of the right eye. He died after three months after we had enquired from his relatives through the phone number they had given us

DISCUSSION

Findings

CONCLUSION