Neuroendocrine Carcinoma Of The Nasal Cavity: Two Case Reports And Review Of The Literature

Objective:Retrospect two clinical cases of neuroendocrine carcinomas of the nasal cavity and review the literature to study the clinical characteristics, pathogenesis, pathological, treatment and prognosis.Material and Method:We analyze two cases of neuroendocrine carcinomas of the nasal cavity diagnosed in 2010 which are from the 1st Affiliated Hospital of Zhejiang University. Simultaneously, we review the literatures in the PubMed database of the National Library of Medicine online, the Wanfang database system and the VIP information database.Result:Case one:A 62 year-old man who got the right-sides nasal obstruction, epistaxis as well as numbness. The tumor lesion which was incanus and had filled the right nasal cavity was observed. CT revealed a mass lesion with a marked contrast enhancement in the right nasal cavity, maxillar sinus, frontal sinus, ethmoid sinus and sphenoid sinus. He was treated by lateral rhinotomy combined with chemotherapy and radiation. No recurrence was occurred during the follow-up of 7 months. The histopathological diagnosis confirmed neuroendocrine carcinoma.Case two:A 56 year-old man presented with numbness of left upper lip as well as left maxillar sinus area and left-sided nasal obstruction. Physical examination showed the submucosal mass of left-sided basis nasi, external wall of the nasal cavity, nasopharynx and hard palate. MRI revealed a tumor mass with a marked contrast enhancement in left-sided nasal cavity, Maxillar sinus and nasopharynx. T1WI showed low signal while T2WI had high signal. The result of an endoscopic biopsy approved neuroendocrine carcinoma. He was treated by chemotherapy and radiation. There was no recurrence during the follow-up of 8 months.Conclusion:Neuroendocrine carcinomas of the nasal cavity are rare tumors and the cause of it may be related to radiation exposure. The clinical features are diversified. The CT and MRI method can provide some helpful information in some aspect, yet the definite diagnosis relies on pathology. Different treatments should be applied to distinct types of neuroendocrine carcinomas according to their specific conditions. Additional, the prognosis of it is different for various types of neuroendocrine carcinomas. Carcinoid of the nasal cavity has a lowest degree of malignancy, therefore, the overall prognosis after conservative surgery is excellent. The mainstay of treatment for atypical carcinoid is surgical excision with elective or therapeutic neck dissection. In some situation, irradiation and chemotherapy should be considered as well. The prognosis is not good. Small cell neuroendocrine carcinoma is highly aggressive and the treatment is included irradiation and chemotherapy. However, the prognosis is still very poor.