PMC7223201_01
Coronal computed tomogram with contrast showing initial carcinoma in situ involving the right septum.
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Haematoxylin and eosin-stained tissue sections. (a) Carcinoma in situ within inverted sinonasal papilloma at 200x magnification. (b) Invasive squamous cell carcinoma at 40x magnification.
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Biopsy of the right nasal septal lesion showed a papillary carcinoma in situ, compatible with an origin in a Schneiderian papilloma (Figure 3(a)). A right myringotomy with grommet insertion was performed in addition to biopsy of a solitary exophytic lesion of the right Eustachian tube orifice, which turned out to be an invasive poorly differentiated carcinoma with some squamous features (Figure 3(b) and Figure 5).
Endoscopic view of the nasopharynx. Recurrence of carcinoma in situ arising in Schneiderian papilloma from the posterior nasopharyngeal wall and extending into the fossa of Rosenmuller. This was 2.5 years following the initial presentation.
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Surgery confirmed an extensive exophytic papillomatous lesion arising from the posterior nasopharyngeal wall and extending into the fossa of Rosenmuller, which was subsequently resected endoscopically (Figure 4).
Endoscopic view of the post-nasal space. Recurrence of an invasive poorly differentiated carcinoma at the right eustachian tube orifice 6 years after the initial presentation.
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A right myringotomy with grommet insertion was performed in addition to biopsy of a solitary exophytic lesion of the right Eustachian tube orifice, which turned out to be an invasive poorly differentiated carcinoma with some squamous features (Figure 3(b) and Figure 5).
Computed tomogram with contrast. (a) Coronal view showing malignancy centred in the right post-nasal space with skull base and prevertebral space invasion, likely extension into the medial part of the right temporal lobe and malignant adenopathy. (b) Axial view showing extensive nodal disease.
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CT and magnetic resonance (MR) imaging revealed a T4 N2b M0 malignancy centred in the right post-nasal space with skull base and prevertebral space invasion, likely extension into the medial part of the right temporal lobe and malignant adenopathy (Figure 6).