Small Cell Neuroendocrine Carcinoma of the Nasal Cavity and Paranasal Sinuses: A Case Report

Background and Aim: Small cell neuroendocrine carcinomas (SNECs) of the sinonasal tract are extremely uncommon tumors and difficult to diagnose by conventional histological examination.

Case Report: We describe a 73-year-old man who presented to the ENT Department of Hippokrateion General Hospital with a long-standing history of right-sided nasal obstruction and hyponasal speech and three episodes of epistaxis. Physical examination revealed an exophytic tumor mass of the right nasal cavity, and CT scan showed a mass of the right nasal cavity that extended to the right maxillary sinus, ethmoidal cells, and right sphenoid sinus. The patient underwent a functional endoscopic removal of the tumor.

Result: The histological examination revealed positive immunoreaction to neuroendocrine markers and lack of olfactory maturation that is consistent with a SNEC diagnosis.

Conclusions: Little is known about the management of these tumors, which have pathological features similar to those of anaplastic cell carcinomas of the lung. Small cell neuroendocrine carcinomas have poor survival rates due to high rates of locoregional failure and distant metastasis. Because of the small numbers of cases reported, no major conclusions or therapeutic recommendations can be made. However, a multidisciplinary treatment approach combining surgery or radiation therapy with chemotherapy is suitable for treating these aggressive tumors.