Aggressive verrucous carcinoma of the paranasal sinuses invading the orbit: Case report and literature review

Abstract

Introduction: Verrucous carcinoma is a variant of well differentiated squamous cell carcinoma characterised by an exophytic, warty growth which is slowly but locally invasive and which can cause extensive local destruction if left untreated.Case report: We report the first known case of veruccous carcinoma of the paranasal sinuses with rapid orbital invasion. A 58-year-old man presented with right-sided nasal obstruction, a huge right intranasal lesion, intractable dacryocystitis and cutaneous involvement of the nasolacrimal sac region. The tumour was partially removed using an endoscopic transnasal approach. Post-operatively, and while waiting for the histological result, the patient developed signs of rapid invasion of the orbit, with uniocular visual acuity deficit. He underwent combined radiochemotherapy, with a moderate response.Conclusion: Knowledge of the potentially aggressive nature of verrucous carcinoma may be helpful in early management of intraorbital invasion and salvaging of the eye. © 2009 Copyright JLO (1984) Limited