Papillary Variant of Intestinal-Type Sinonasal Adenocarcinoma in an Elderly Female Nigerian: A Case Report

Abstract

Intestinal-type sinonasal adenocarcinomas (ITAC) are rare tumours accounting for about 1.4% of all neoplasms and less than 4% of all sinonasal malignancies. The papillary variant accounts for 18% of ITAC, with few cases reported worldwide and no known documented case in Nigeria. This variant has the best prognosis but can easily be misdiagnosed. Most ITAC occurs in men with a history of long-term exposure to sawdust. There are very few reported cases among farmers. This report describes a rare case of a papillary variant of ITAC in an 83-year-old Nigerian retired female farmer who presented with a 10-month history of recurrent nasal discharge and blockage. The diagnosis was made following a paranasal CT scan and histology with immunohistochemistry of the debulked nasal mass. ITAC should be suspected in patients with chronic unilateral nasal obstruction, rhinorrhea, epistaxis, and long-term exposure to sawdust or leather dust and agricultural produce or products.