Schneiderian carcinoma

Common Signs and Symptoms

Schneiderian carcinoma, also known as Sinonasal Undifferentiated Carcinoma (SNUC), can present with a range of symptoms, including:

• Nasal obstruction: This is the most common presenting symptom, where patients experience difficulty breathing through one nostril.
• Epistaxis: Patients may experience nosebleeds due to the tumor's location and growth pattern.
• Headache: The tumor can cause pain and pressure in the head and face area.
• Facial pain: Some patients may experience pain or tenderness on one side of the face.
• Nasal discharge: Patients may notice a change in nasal drainage, which can be clear or bloody.

These symptoms are often similar to those experienced by patients with chronic rhinosinusitis, making it essential for healthcare providers to consider SNUC as a potential diagnosis in patients presenting with these symptoms [1][2].

Additional Symptoms

In some cases, Schneiderian carcinoma may also present with:

• Double vision: The tumor can grow and press on the nerves controlling eye movement.
• Bulging eye: As the tumor grows, it can cause the eye to bulge or protrude from its socket.
• Chronic infections: Patients may experience recurring sinus infections due to the tumor's presence.

It is essential for patients experiencing these symptoms to seek medical attention promptly, as early diagnosis and treatment can significantly improve outcomes [3][4].

References

[1] Symptoms in patients typically begin with complaints similar to chronic rhinosinusitis, including nasal congestion, drainage, headaches and postnasal drip. (Search result 1)

[2] Sinonasal undifferentiated carcinoma is a rare malignant neoplasm of the nasal cavity and/or paranasal sinuses that can infiltrate the orbit. ... SNUC commonly presents as nasal obstruction, epistaxis, headache, and facial pain; however... (Search result 2)

[3] Initial symptoms range from bloody nose, runny nose, double vision, and bulging eye to chronic infections and nasal obstruction. (Search result 3)

[4] Inverted papillomas can cause nasal congestion, nasal draining or postnasal drip, and a small amount of bleeding from the nose. Other symptoms may include... (Search result 4)

Diagnostic Tests for Schneiderian Carcinoma

Schneiderian carcinoma, also known as Schneiderian papilloma carcinoma or carcinomas ex-Schneiderian papilloma, is a rare type of cancer that affects the Schneiderian epithelium in the sinonasal tract. Diagnosing this condition can be challenging due to its rarity and similarity in appearance to other benign tumors.

Imaging Studies

• Computed Tomography (CT) Scanning: CT scans are often used to visualize the extent of the tumor and assess for any potential invasion into surrounding structures [6].
• Magnetic Resonance Imaging (MRI): MRI can provide detailed images of the tumor and its relationship with adjacent tissues, which is particularly useful in cases where surgical resection is being considered [7].

Biopsy

• Biopsy: A biopsy is the most important diagnostic tool for Schneiderian carcinoma. It involves taking a sample of tissue from the suspected tumor site for histopathological examination [5]. The biopsy can help differentiate Schneiderian carcinoma from other benign tumors, such as papillomas.

Immunohistochemistry

• CK5/6 and p63: Immunohistochemical studies have shown that Schneiderian carcinomas are positive for CK5/6 (86%) and p63 (86%) [8].
• p53: The majority of Schneiderian carcinomas also show positivity for p53 (83%) [8].

Other Diagnostic Tests

• Flexible Endoscopy: Flexible endoscopy can be used to visualize the tumor site and assess for any potential invasion into surrounding structures.
• Plain Radiography: Plain radiographs may be used to evaluate the extent of the tumor and assess for any potential bone involvement.

It's worth noting that a combination of imaging studies, biopsy, and immunohistochemistry is often necessary to accurately diagnose Schneiderian carcinoma.

The differential diagnosis of Schneiderian carcinoma, also known as Schneiderian papilloma or Low-grade papillary Schneiderian carcinoma (LGPSC), involves several entities that can mimic its appearance and behavior.

Key Differential Diagnoses:

• Sinonasal papilloma: This is a benign tumor that can be difficult to distinguish from LGPSC, especially in its early stages. Sinonasal papillomas are characterized by a bland morphology simulating sinonasal papilloma, invasive growth pattern with pushing borders, and aggressive clinical behavior with multiple recurrences and metastatic potential [1].
• Carcinoma arising in a sinonasal papilloma: This is a type of cancer that develops within a pre-existing sinonasal papilloma. It can be challenging to distinguish from LGPSC, especially if the carcinoma is low-grade [13].
• Squamous cell carcinoma: This is a type of cancer that can arise from the Schneiderian epithelium and can be difficult to distinguish from LGPSC, especially in its early stages [12].

Other Differential Diagnoses:

• Inverted papilloma: This is a type of benign tumor that can be mistaken for LGPSC, especially if it has an invasive growth pattern [14].
• Respiratory epithelial adenomatoid hamartoma (REAH): This is a rare benign tumor that can be difficult to distinguish from LGPSC, especially in its early stages [15