[Cancers of the nasal cavity and paranasal sinuses: clinicopathological, etiological and therapeutic aspects]

Liver metastasis of ethmoid sinus adenocarcinoma

INTRODUCTION

Sinonasal cancer is an uncommon neoplasm, often associated with exposure to occupational hazards and delayed diagnosis.

CASE REPORT

The authors report a rare case of solitary liver metastasis from ethmoid sinus adenocarcinoma treated by surgical resection. No clinical or radiological sign of recurrence was observed with a follow-up of 3 months.

DISCUSSION

Adenocarcinoma of the ethmoid sinus is characterized by its aggressiveness and its tendency to recurrence. Metastases are rare and can be found in unexpected organs due to dissemination via collateral venous plexuses. The role of chemotherapy has not been clearly established. Due to their rarity, the treatment of metastases has not yet been defined.

Sinonasal cancer and occupational exposure in a population-based registry

We examined occupational exposures among subjects with sinonasal cancer (SNC) recorded in a population-based registry in the Lombardy Region, the most populated and industrialized Italian region. The registry collects complete clinical information and exposure to carcinogens regarding all SNC cases occurring in the population of the region. In the period 2008-2011, we recorded 210 SNC cases (137 men, 73 women). The most frequent occupational exposures were to wood (44 cases, 21.0%) and leather dust (29 cases, 13.8%), especially among men: 39 cases (28.5%) to wood and 23 cases (16.8%) to leather dust. Exposure to other agents was infrequent (<2%). Among 62 subjects with adenocarcinoma, 50% had been exposed to wood dust and 30.7% to leather dust. The proportions were around 10% in subjects with squamous cell carcinoma and about 20% for tumors with another histology. The age-standardized rates (×100,000 person-years) were 0.7 in men and 0.3 in women. Complete collection of cases and their occupational history through a specialized cancer registry is fundamental to accurately monitor SNC occurrence in a population and to uncover exposure to carcinogens in different industrial sectors, even those not considered as posing a high risk of SNC, and also in extraoccupational settings.