Primary Neuroendocrine Carcinoma of Sinonasal Tract Infiltrating Maxilla

Abstract

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.