2023 Volume 62 Issue 2 Pages 344-349
HPV-related multiphenotypic sinonasal carcinoma (HMSC) is a recently classified disease, with only a few case reports in Japan, and the disease concept is not widely recognized. HMSC is characterized by localization to the nasal sinuses, diverse histopathological features such as squamous cell dysplasia and adenoid cystic carcinoma, and the presence of high-risk HPV (mainly type 33) infection. While the disease commonly has high-grade histological features, it also often has a relatively slow course, which makes it important to distinguish HMSC from squamous cell carcinoma, adenoid cystic carcinoma, and other types of carcinoma. In this study, we report a case of HPV-associated nasal sinus cancer in which HPV type 33 was detected. The patient was a 44-year-old woman who visited our hospital with a chief complaint of epistaxis. A hemorrhagic tumor occupying the right middle nasal passage and posterior nostril was noted. Based on histological diversity and positive p16 immunostaining on biopsy, a diagnosis of HMSC was made and the patient underwent surgical treatment. HMSC is similar in histologic morphology to adenoid cystic carcinoma and squamous cell carcinoma. In specimens of nasal sinus carcinoma in which HMSC is suspected, it is important to perform p16 staining, as in mesopharyngeal carcinoma, and if the specimen shows diffuse positive findings, specific tests such as in situ hybridization and PCR should be performed to diagnose HMSC, with the assumption of HPV-related carcinoma.
