鼻腔原発非腸管型腺癌例

We describe the case of a patient with non-intestinal-type adenocarcinoma (non-ITAC) of the nasal cavity, because this tumor is very rare. A-79-year-old woman was referred to us with a 1-month history of pain and swelling behind the nose on the left side and discharge from the left eye. A rubbery, soft lesion measuring approximately 3 cm in diameter arising from behind the left nose was recognized. The lesion was suspected as a submucosal tumor at the front of the nasal cavity. There was no impairment of vision or eye movements. Cytology was class V (carcinoma), and the imaging findings were consistent with a submucosal tumor at the front of the nasal cavity; no cervical lymph node metastasis or distant metastasis was observed. Tumor resection was performed under general anesthesia. Histopathologic examination of the tumor revealed the tumor as being a non-ITAC, an entity included in the WHO classification of adenocarcinomas. The patient developed tumor recurrence after surgery, and died of metastatic cancer two years one month after her first visit to us. The prognosis of patients with high-grade non-ITAC is poor and multidisciplinary treatment is often considered. Postoperative radiotherapy should be considered based on the histopathology, extent of invasion of the primary tumor, and status of the surgical margin.