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Intestinal Sinonasal Adenocarcinoma: a Deceptive Malignant Neoplasm of the Sinonasal Region Cover

Intestinal Sinonasal Adenocarcinoma: a Deceptive Malignant Neoplasm of the Sinonasal Region

Forum of Clinical Oncology
AHEAD OF PRINT
By: G Subhas Babu,  Sivadas K Smrithy,  Shruthi Hegde,  Vidya Ajila,  Mangesh Shenoy and  Yashika Jain  
Open Access
|Oct 2025

Figures & Tables

Figure 1:

Extraoral swelling seen with respect to middle one third of right side of face. 1A and 1B: Extension of swelling involving the ala of nose medially, laterally along the vertical line drawn from outer canthus of eye, superiorly involving the infraorbital region with sunken eyes, and inferiorly along the horizontal line drawn from right commissure of lip. 1C: Bird’s view showing the swelling involving the infraorbital region with respect to right side with subsequent shrinking of right eye. 1D: Left profile view showing the normal appearance when compared to the right side.
Extraoral swelling seen with respect to middle one third of right side of face. 1A and 1B: Extension of swelling involving the ala of nose medially, laterally along the vertical line drawn from outer canthus of eye, superiorly involving the infraorbital region with sunken eyes, and inferiorly along the horizontal line drawn from right commissure of lip. 1C: Bird’s view showing the swelling involving the infraorbital region with respect to right side with subsequent shrinking of right eye. 1D: Left profile view showing the normal appearance when compared to the right side.

Figure 2:

Intraoral swelling present with respect to vestibular region and palate. 2A and 2B: Proliferative vascular growth seen extending from the attached gingiva with respect to 12 to interdental space between 16 and 17 and superiorly involving the buccal vestibule 2C and 2D: Well-defined ovoid swelling seen extending from the interdental space between 15 and 16 was seen crossing the midline and posteriorly extending till the junction of hard and soft palate.
Intraoral swelling present with respect to vestibular region and palate. 2A and 2B: Proliferative vascular growth seen extending from the attached gingiva with respect to 12 to interdental space between 16 and 17 and superiorly involving the buccal vestibule 2C and 2D: Well-defined ovoid swelling seen extending from the interdental space between 15 and 16 was seen crossing the midline and posteriorly extending till the junction of hard and soft palate.

Figure 3:

CBCT images showing the radiographic presentation of the lesion. 3A: Panoramic reconstructed image showing an ill-defined mixed radiolucent radiopaque lesion in the right maxilla, extending mediolaterally from nasal septum to zygoma and superoinferiorly from right orbit to maxillary alveolus and palate along with bone loss present around 13–18 region. 3B, 3C, 3D: Axial section showing the destruction of the floor of right orbit, anterolateral, and posterolateral wall of right maxillary sinus and nasal septum.
CBCT images showing the radiographic presentation of the lesion. 3A: Panoramic reconstructed image showing an ill-defined mixed radiolucent radiopaque lesion in the right maxilla, extending mediolaterally from nasal septum to zygoma and superoinferiorly from right orbit to maxillary alveolus and palate along with bone loss present around 13–18 region. 3B, 3C, 3D: Axial section showing the destruction of the floor of right orbit, anterolateral, and posterolateral wall of right maxillary sinus and nasal septum.

Figure 4:

The unique radiographic pattern shown by adenocarcinoma as a result of destruction. 4A: Coronal section showing the mixed radiolucent radiopaque lesion causing destruction of nasal septum and giving rise to sunburst appearance. 4B and 4C: Axial section showing the mixed radiolucent radiopaque lesion showing destruction of nasal septum and zygoma giving the sunburst appearance. 4D: Sagittal section showing the sunburst pattern with respect to the floor of right maxillary sinus and nasal septum along with bone loss seen with respect to 13–18 region.
The unique radiographic pattern shown by adenocarcinoma as a result of destruction. 4A: Coronal section showing the mixed radiolucent radiopaque lesion causing destruction of nasal septum and giving rise to sunburst appearance. 4B and 4C: Axial section showing the mixed radiolucent radiopaque lesion showing destruction of nasal septum and zygoma giving the sunburst appearance. 4D: Sagittal section showing the sunburst pattern with respect to the floor of right maxillary sinus and nasal septum along with bone loss seen with respect to 13–18 region.

Figure 5:

Destruction pattern of the lesion in axial view. 5A: Destruction of the right lateral wall of nasal cavity and inferior turbinates. 5B: Mixed radiolucent radiopaque lesion caused destruction of anterolateral and posterolateral wall and floor of right maxillary sinus and nasal cavity. 5C: The mixed radiolucent radiopaque lesion seen crossing the midline of the palate at the posterior region. 5D: Mixed radiolucent radiopaque lesion produces sunburst appearance at the right zygoma region
Destruction pattern of the lesion in axial view. 5A: Destruction of the right lateral wall of nasal cavity and inferior turbinates. 5B: Mixed radiolucent radiopaque lesion caused destruction of anterolateral and posterolateral wall and floor of right maxillary sinus and nasal cavity. 5C: The mixed radiolucent radiopaque lesion seen crossing the midline of the palate at the posterior region. 5D: Mixed radiolucent radiopaque lesion produces sunburst appearance at the right zygoma region

Figure 6:

Histopathological images. 6A–6D: Pleomorphic tumor cells exhibited hyper chromatic vesicular nuclei and eosinophilic cytoplasm were arranged in glandular, cribriform, and papillary pattern. Glands with intraluminal necrosis were noted along with lymphovascular and perineural invasion.
Histopathological images. 6A–6D: Pleomorphic tumor cells exhibited hyper chromatic vesicular nuclei and eosinophilic cytoplasm were arranged in glandular, cribriform, and papillary pattern. Glands with intraluminal necrosis were noted along with lymphovascular and perineural invasion.

Immunohistochemical and Histopathological features of Intestinal Sinonasal Adenocarcinoma_

IMMUNOHISTOCHEMICAL MARKERSHISTOPATHOLOGICAL FEATURES
Pancytokeratin and CK7: Indicates keratin producing cellsTubulo-glandular architecture: Consists of tubules and glands
MUC2: Mucin proteinPapillary appearance: Papillary elements
CK20, CDX2, and SATB2: Negative inITACColonic resemblance: Histopathological resemblance to colonic adenocarcinoma
S100 protein, SOX10, and Discovered on GIST-1(DOG1): Indicatesneuroendocrine differentiationSignet ring cell morphology
Carcinoembryonic Antigen (CEA): Weak expression than colonicadenocarcinomaGoblet cells : Present in papillary and mucinous subtypes
Chromogranin: Numerous Chromogranin positive cells compared tocolonic adenocarcinomaPositive mitotic activity
DOI: https://doi.org/10.2478/fco-2024-0013 | Journal eISSN: 1792-362X | Journal ISSN: 1792-345X
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Language: English
Submitted on: Nov 2, 2024
Accepted on: Jul 2, 2025
Published on: Oct 10, 2025
Published by: Helenic Society of Medical Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 2 issues per year
Keywords:
adenocarcinoma,
intestinal-type adenocarcinoma,
paranasal sinus,
wood dust
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Haematology, oncology

© 2025 G Subhas Babu, Sivadas K Smrithy, Shruthi Hegde, Vidya Ajila, Mangesh Shenoy, Yashika Jain, published by Helenic Society of Medical Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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