Small Cell Undifferentiated Carcinoma of the Sphenoid Sinus

Abstract

Small cell undifferentiated carcinoma in the head and neck region is very rare. We describe our experience with a rare case of small undifferentiated carcinoma of the sphenoid sinus.
The patient was a 71-year-old woman who had complained of persistent nasal obstruction and nasal bleeding. She underwent endoscopic surgical resection of the sphenoid sinus tumor and neck lymph node dissection.
Histological investigation revealed diffuse proliferation of tumor cells slightly larger than lymphocytes and positive immunostaining for S-100, CD56, and AE1/AE3, leading to the diagnosis of small cell undifferentiated carcinoma.
After the surgery, she received chemotherapy with irinotecan and cisplatin and radiotherapy. Nineteen months after the initial treatment, multiple bone and lung metastases were detected.
The patient desired palliative care and has since been treated with low-dose chemotherapy on an outpatient basis.
Small cell undifferentiated carcinoma has a poor prognosis, and so far there is no established standard therapeutic protocol. Here, we report and further discuss the clinical implications based on a literature review.