A rare malignancy of sinonasal tract- transitional cell carcinoma: a case report

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Prakash S.B1, Nishan2


Prakash SB, Nishan. “A rare malignancy of sinonasal tract- transitional cell carcinoma: a case report”. Journal of Evolution of Medical and Dental Sciences 2013; Vol2, Issue 36, September 9; Page: 6946-6950.

ABSTRACT: A 30-year old female presented with a 8-month history of left nasal obstruction associated with recurrent episodes of epistaxis. Left nasal cavity was filled with polypoidal mass. Computed tomography revealed a mass present in the left nasal cavity, appears to be arising from ethmoidal air cells and lateral nasal wall. Diagnostic Nasal Endoscopy was done and biopsy was taken. Report came as sinonasal malignancy of transitional cell type. Endoscopy assisted, surgical excision of the mass was done and later she was referred higher centre for further management. Non-keratinizing carcinoma (Transitional type) of the sinonasal tract is a rare entity and there are only few reports concerning this type of malignancy. This may be partly because of its diagnostic difficulty due to many synonyms such as Schneiderian carcinoma, cylindrical cell carcinoma and transitional cell carcinoma.

KEYWORDS: Non-keratinizing carcinoma, Schneiderian carcinoma, Transitional cell carcinoma, Cylindrical cell carcinoma, Ringertz carcinoma, Respiratory epithelial carcinoma.
CASE REPORT: A 30 year old female, housewife from Mysore district presented to our OPD with a 8-months history of progressively worsening left nasal obstruction associated with episodes of epistaxis. There were no other symptoms in this previously well lady.

Clinical examination showed a pinkish, polypoidal mass filling entire left nasal cavity, can be probed all around except on its lateral aspect, insensitive and bleeds on touch. Nasal septum was deviated to the opposite side.

Figure 1: Endoscopic image of left nasal

cavity showing pinkish mass filling

entire nasal cavity, insensitive and bleeds on touch.

Posterior rhinoscopy showed mass filling the left choana. A complete head and neck examination did not reveal any evidence of cervical lymphadenopathy.

A computed tomography scan of the paranasal sinuses showed homogeneously-enhancing mass in the left nasal cavity, ethmoidal region, left choana and pushing the nasal septum to the right side. The mass appeared to be arising from the left anterior ethmoidal air cells and from lateral wall. There was also thinning and displacement of the ipsilateral lamina papyracea noted but no evidence of any bony erosion. Cribriform plate was not eroded.

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