Sinonasal Adenocarcinoma
Michelle A. Michel, MD
Key Facts
Terminology
Malignant neoplasm with glandular differentiation, or arising from surface epithelium or minor salivary rests
Imaging
Predilection for nasal cavity & ethmoid sinuses
May reach large size due to delay in diagnosis
75% with involvement of > 1 SN area at diagnosis
CT
Well- to poorly defined soft tissue density mass
Bone destruction > remodeling
MR
Typically intermediate to hyperintense T2 signal
Diffuse, heterogeneous enhancement
Top Differential Diagnoses
Sinonasal squamous cell carcinoma
Esthesioneuroblastoma
Sinonasal undifferentiated carcinoma
Sinonasal non-Hodgkin lymphoma
Pathology
Confusion remains regarding histologic classification of sinonasal adenocarcinoma
2 major subtypes
Intestinal (related to wood dust exposure): Most frequent form colonic > solid > papillary > mucinous & mixed type
Nonintestinal: Unrelated to wood dust exposure
Accounts for 15% of all SN cancers
Clinical Issues
6th decade most common
M > F (≈ 3:1)
Poor prognosis with higher grades, incomplete resection, & intracranial involvement
Complete surgical excision for cure
 (Left) Axial CECT shows a large, heterogeneously enhancing adenocarcinoma filling the upper nasal cavity and ethmoid sinuses. There is anterior extension into the soft tissues of the nasal dorsum
 and destruction of the lamina papyracea  . (Right) Sagittal T1WI MR shows a large adenocarcinoma filling the nasal cavity and extending into the nasopharynx  . No extension through the skull base  is seen. The lesion extends into the subcutaneous fat  anteriorly.Related posts: Stay updated, free articles. Join our Telegram channel
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