Endoscopic resection of sinonasal adenoid cystic carcinoma with radiofrequency coblation. A clinical report with literature review
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Introduction Sinonasal cancer is very rare and accounts for under 1% of all malignancies of which sinonasal adenoid cystic carcinoma (SNACC) is about 5%. The maxillary sinus is the most common site of SNACC. Misleading symptomatology which overlaps with rhinosinusitis contributes to the delay of diagnosis. Recently, the endoscopic approach is commonly applied with equal or better results to the open approach. Radiofrequency coblation might be used to reduce blood loss. Material and Methods We present a case of an adenoid cystic carcinoma arising from the left inferior turbinate. The patient received endoscopic surgical treatment with the application of radiofrequency coblation in Clarós Clinic at the beginning of 2019 and remains followed up with no sign of recurrence. Afterward, we review the literature on the subject. Conclusion SnACC is a rare malignancy, characterized by slow growth and perineural infiltration with spreading towards the skull base, cavernous sinus, and orbit. The regional nodal involvement is rare. Frequent and delayed distant metastasis in lung, bone, liver, and brain are also typical. Prognosis is poor with the 5-year overall survival between 41%-86%. Surgery with or without complementary radiotherapy provides the best outcomes for the majority of patients. The significance of prognostic factors remains unclear. Lifelong surveillance is obligatory as very late recurrences are common.
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