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Radiology Quiz Case 2: Diagnosis
Arch Otolaryngol Head Neck Surg. 2008;134(9):1011.
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Diagnosis: Adenoid cystic carcinoma (ACC) of the sinonasal tract with perineural spread into the cavernous sinus
Various malignant neoplasms of salivary gland origin, including adenocarcinoma, ACC, and mucoepidermoid carcinoma, can develop in the sinonasal tract. Adenoid cystic carcinoma is the most common.1-2 The characteristic biologic features of the ACC are local recurrence, perineural spread, and late distant metastasis. The maxillary sinus is the most common site of sinonasal ACCs.3-5 In our case, it was difficult to define the tumor origin because of the huge size of the tumor.
Perineural invasion in ACC has been associated with an increased risk of locoregional recurrence or distant metastasis.4-5 However, perineural tumor spread may be asymptomatic; therefore, imaging studies play a critical role in the evaluation. Imaging findings of perineural spread of tumor include thickening and enhancement in the involved nerve, a widened foramen at the skull base, and obliteration of fat around the nerve as it exits the skull base. A combination of T1-weighted images, with and without contrast . . . [Full Text of this Article]
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Radiology Quiz Case 2
Chi-Che Huang and Ta-Jen Lee
Arch Otolaryngol Head Neck Surg. 2008;134(9):1009.
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