Treatment outcomes of sinonasal adenoid cystic carcinoma: a single-center experience

Objective

Sinonasal adenoid cystic carcinoma (ACC) is a rare malignancy characterized by perineural invasion and a high risk of late recurrence. This study examines the clinical characteristics and treatment outcomes of patients with sinonasal ACC treated at a single institution over 15 years.

Patients and methods

A retrospective analysis was conducted on 19 patients with histologically confirmed sinonasal ACC treated at Chonnam National University Hwasun Hospital from 2010 to 2024.

Results

Nasal obstruction was the most common presenting symptom (57.8 %), followed by facial pain and numbness (21.0 %) and epistaxis (10.5 %). The maxillary sinus was the most frequently affected site (52.6 %). At initial diagnosis, regional lymph node and distant metastases were each observed in one patient. Most cases were diagnosed at stage IV (57.9 %), with perineural invasion detected in 31.6 % of cases. Among the 17 patients who completed treatment, surgery followed by radiotherapy was the predominant treatment modality (82.4 %). Two patients were deemed inoperable and received definitive chemoradiotherapy or best supportive care. Over a mean follow-up of 87.5 ± 60.2 months, 11 patients (64.7 %) experienced recurrence, with a mean time to recurrence of 52.8 ± 45.7 months. Survival analysis identified tumor stage as the only significant prognostic factor (p < 0.05).

Conclusion

Sinonasal ACC is frequently diagnosed at an advanced stage and demonstrates a high recurrence rate despite multimodal treatment. The tumor stage emerged as the strongest prognostic indicator of survival, highlighting the need for early detection and aggressive therapeutic interventions to improve patient outcomes.