Primary Neuroendocrine Carcinoma of Sinonasal Tract Infiltrating Maxilla

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Professor, Consultant Pathologist, American Board Certified Pathologist, Fellow College of American Pathologists. Areas of interest Fine Needle Aspiration Cytology, Cytology, Cancer, Ethics, Islam, Humanity

Primary Neuroendocrine Carcinoma of Sinonasal Tract Infiltrating Maxilla

Kanwal Zahra, Shaista Khurshid, Ahmareen Khalid and Ashok Kumar Tanwani
Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad

Objective: Report an unusual case of primary neuroendocrine carcinoma of sinonasal tract involving maxilla.
Background: Neuroendocrine tumors are rare in head and neck region and pose a challenge in regard of pathologic diagnosis. Neuroendocrine carcinoma of sinonasal tract is extremely uncommon tumor and despite aggressive management strategies it carries a poor prognosis with a high risk of local recurrence or distant metastases. Very few cases of sinonasal neuroendocrine carcinoma have been reported till date.
Case Presentation: A 35year female resident of Rawalpindi presented with slowly growing expansile swelling of left maxilla since two and a half years. Initial biopsy was labeled as fibrous dysplasia. We
received a maxillectomy specimen. After reviewing the morphology on H&E slides and with help of immunohistochemistry she was diagnosed with sinonasal neuroendocrin carcinoma (moderately differentiated) infiltrating maxilla. Patient is now on palliative chemoradiotherapy.
Conclusion: Neuroendocrine carcinoma is a rare entity in head and neck region especially in sinonasal area. It is important to recognize their morphology and pattern of growth because they cannot be mistaken with more common tumors of this area e.g squamous cell carcinoma (poorly differentiated), sinonasal undifferentiated carcinoma (SNUC) and olfactory neuroblastoma.
Key words: Neuroendocrine carcinoma, Olfactory Neuroblastoma, Squamous cell carcinoma, Sinonasal
Undifferentiated Carcinoma (SNUC).


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