Primary frontal sinus cancer is a rare disease. Herein, we report a case of frontal sinus cancer that developed around a T-tube that had been placed in the frontal sinus for a long time.
A 77-year-old man with dementia living in a nursing home developed proptosis of the left eyeball, and MRI revealed a shadow around the left orbit. The tumor was suspected to have extended from the sinuses. CT revealed an opacity that was thought to be a T-tube in the frontal sinus, a soft shadow in the left frontal sinus that displaced the left orbit, and some bone destruction. Inside the nose, the T-tube stump was found in the left middle nasal meatus, around which there was increased granulation and purulent nasal discharge. It was unclear when the frontal sinus surgery had been performed and when the tube had been placed.
Left endoscopic nasal sinus surgery was performed via an external incision (Killian’s operation). The T-tube had been placed through the left middle nasal meatus into the nasofrontal canal and frontal sinus, and the area around it was filled with granulation tissue. The T-tube was removed, and the granulation tissue and edematous mucosa were removed. Rapid intraoperative diagnosis revealed SCC in situ of the frontal sinus, and permanent postoperative histopathology confirmed the definitive diagnosis. Considering the patient’s complications and general condition, we decided to provide best supportive care rather than aggressive treatment.
In this case, the malignant tumor was thought to have developed from the frontal sinus mucosa due to persistent physical stimulation from the long-term indwelling tube and chronic inflammation caused by foreign body reaction.
