A Rare Case of High-Grade Non-intestinal Sinonasal Adenocarcinoma

The sinonasal region is frequently associated with malignancies, but adenocarcinomas are extremely rare, especially the non-intestinal type. The symptoms of a disease are usually non-specific, making a diagnosis difficult until the disease has reached a late stage. Radiographic studies are essential for determining the stage of the disease and planning the surgical procedure. The endonasal surgical approach has gained popu-larity in recent years. This case report describes the case of a 49-year-old male who suffered from left nasal obstruction, headaches, recurrent epistaxis, low visual acuity, and proptosis. A magnetic resonance image revealed a contrast-enhancing bulky lesion that occupied the left sinona sal cavity up to the level of the choana. The patient was subjected to an endoscopic procedure employing a centripetal technique, which allowed the medial wall of the orbit and the anterior base of the skull to be preserved while the tumor was completely removed. Upon review of the pathology report, the tumor was identified as a high grade non-intestinal adenocarcinoma. Tumors of this type are more common in men and can affect anyone from teenagers to older adults. A nasal obstruction is the most common symptom, but swelling and facial deformity may also be present. This tumor is characterized by a solid pattern and is an invasive cancer that has an aggressive nature. The level of pleomorphism is moderate to severe, with a high mitotic index and atypical mitoses as well as necrosis. There is CK7 positivity in the immunohistochemistry pattern, while CK20 and CDX-2 are negative. The diagnosis poses a number of challenges. An immunohistochemical study and a histological examination are essential in order to confirm these findings. An accurate classification of the disease is critical for determining its prognosis.