Large-cell neuroendocrine carcinoma of nasal cavity and paranasal sinuses after successful curative therapy: a case report and literature review

Large Cell Neuroendocrine Carcinoma in the Sinonasal Cavity with Large Intracranial Extension Treated with Endonasal Endoscopic and Transcranial Combined Surgery: A Case Report

Large cell neuroendocrine carcinoma (LCNEC) is a rare malignant tumor that typically arises in the lungs. It is especially rare in the sinonasal cavity, and treatment has not been established. In this study, we present the case of a 56-year-old woman with a large sinonasal LCNEC that extended into her brain. We performed endonasal endoscopic and transcranial combined surgery followed by chemoradiation therapy. The combined surgery enabled us to approach and remove the extensive tumor from two different directions at one time less invasively. We have achieved good tumor control for 18 months so far.

Neuroendocrine carcinoma of the nasal cavity with epiphora as the first symptom: A case report

RATIONALE

Neuroendocrine carcinomas (NECs) are rare malignancies that originate from the hormone-producing cells of the neuroendocrine system. They can grow in most organs of the body but are commonly found in the gastrointestinal and respiratory tracts. The nasal cavity is a rare site for NECs.

PATIENT CONCERNS

We report a case of NECs in a 45-year-old woman who presented with epiphora in the right eye for a year owing to an unknown reason.

DIAGNOSES

The diagnosis was initially confirmed via histological and immunohistochemical assays. Postoperatively, computed tomography of the neck revealed C4 vertebral bone metastasis.

INTERVENTIONS

The tumor was endoscopically removed from the right eye. The patient received a full course of adjuvant polychemotherapy.

OUTCOMES

Six months after diagnosis, the patient died due to bone metastasis.

LESSONS

Diagnosing nasal neuroendocrine carcinoma is clinically challenging. It must be distinguished from other orbital masses, such as chronic dacryocystitis or nasal polyps. The treatment should be further investigated for this rare malignancy in near future.