| Background:Nonkeratinizing squamous cell carcinoma(NKSCC)is common in the nasopharynx,nasopharyngeal carcinoma accounted for about 95%,and rare in the nasal cavity and paranasal sinuses.At present domestic and foreign literatures about nasal NKSCC rarely reported for the case,and the name is more chaotic,except NKSCC,transitional cell carcinoma,cylindrical cell carcinoma,Schneiderian carcinoma,Ringertz tumor,respiratory epithelial carcinoma and so on.In 2017 the World Health Organization(WHO)classification on head and neck cancer tissue(4th Edition)in sinonasal squamous cell carcinoma(SCC)is divided into keratinizing squamous cell carcinoma(KSCC),nonkeratinizing squamous cell carcinoma(NKSCC),spindle cell squamous cell carcinoma,lymphoepithelioid squamous cell carcinoma,verrucous squamous cell carcinoma and so on.Not just because of the histopathological differences,it is also because observational studies have found that NKSCC is more sensitive to radiotherapy than KSCC,and is less likely to have lymph node metastasis.More and more recent studies have shown that NKSCC has a higher risk of breast cancer than other types of malignant tumors in the paranasal and paranasal sinuses.Head tumor virus(HPV)infection rate.Because the clinical features ofNKSCC in nasal cavity and paranasal sinus are relatively rare,its clinical symptoms are not typical,it is not easy to find them early,and its histopathological features are complex and changeable,and it is difficult to diagnose the disease,the literature at home and abroad lacks the systematic understanding of the disease and the summary of diagnosis and treatment experience.It is easy to cause misdiagnosis and missed diagnosis.Objective:The clinical features,imaging features,histopathological features,treatment and prognosis of patients with NKSCC in nasal cavity and paranasal sinus were discussed in order to improve the understanding of the disease and reduce the misdiagnosis and missed diagnosis.Methods:The clinical data of 3 cases of NKSCC in nasal cavity and paranasal sinus confirmed by pathology from January 2015 to February 2018 in the Department of Otorhinolaryngology of the second Hospital of Jilin University were retrospectively analyzed.The clinical characteristics of NKSCC in nasal cavity and paranasal sinus were summarized in combination with the relevant literatures at home and abroad.Imaging features,histopathological features,treatment and prognosis.Results:In 3 cases of nasal cavity and paranasal sinus NKSCC,2 cases were male and 1 case female,the age was 56 to 76 years old,the median age was 66.7 years,the course of disease was 1-6 months,the median course of disease was 3.7 months.Case 1 was treated with "1 month of right intermittent epistaxis with headache",and case 2 was treated with "leftnasal trunk with blood in snot for 6 months" under electronic nasopharyngoscope.Anterior nasal examination showed pink ulcer in the left Li's area and nasal floor,slightly uneven surface.Case 3 was treated for "subcutaneous eminence of the right medial canthus,pain with tears for 4 months",and right orbital CT scan.Lateral lacrimal sac and right nasal cavity,mass of ethmoid sinus soft tissue shadow,electronic nasopharyngoscopy of the right middle nasal canal pale pink uneven mass.Case 1 was followed up for 16 months under general anesthesia under nasal endoscope,the clinical symptoms disappeared,no recurrence and metastasis were found,and the patient died of heart disease,case 2received radiotherapy and was followed up for 18 months.Case 3underwent tumor resection under general anesthesia combined with lateral nasal resection and received radiotherapy 1 month after operation.Follow up for 18 months no recurrence of sinus MRI was found.Conclusion:1.NKSCC is rare in nasal cavity and paranasal sinus.Otolaryngologists should improve their understanding and avoid misdiagnosis and missed diagnosis.2.NKSCC diagnosis of nasal cavity and paranasal sinus is mainly based on histopathology,combined with clinical manifestation,electronic nasopharyngoscope and imaging examination.3.Surgery is the first choice for the patients with limited lesions,and radiotherapy may be added to the patients with extensive lesions,and the prognosis is good.radiotherapy,and the prognosis was better. |
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