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Head Neck. 2013 Nov;35(11):E343-5. doi: 10.1002/hed.23225. Epub 2013 Mar 8.

Leptomeningeal carcinomatosis in sinonasal undifferentiated carcinoma.

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  • 1Division of Medical Oncology, Keck University of Southern California School of Medicine, USC Norris Comprehensive Cancer Center, Los Angeles, California.

Abstract

BACKGROUND:

Sinonasal undifferentiated carcinoma (SNUC) is an uncommon neoplasm characterized by local extension and an aggressive course. Treatment often includes a combination of chemotherapy, radiation therapy, and surgery, although the optimal strategy remains unclear. Here, we present the first reported case of leptomeningeal carcinomatosis from SNUC.

METHODS AND RESULTS:

A 28-year-old man with rapidly progressive headaches, congestion, and exophthalmos was found to have a nasal mass. Biopsy revealed sinonasal undifferentiated carcinoma. He had a transient response to chemotherapy followed by a sustained response to concurrent chemoradiation. At the completion of radiation, he developed subtle neurologic findings and MRI revealed diffuse, bulky leptomeningeal spread. He was able to receive only a single fraction of external beam radiation to his spinal axis before his disease rapidly progressed, leading to respiratory failure and death.

CONCLUSIONS:

Sinonasal undifferentiated carcinoma can be associated with leptomeningeal carcinomatosis, which can lead to a fulminant clinical course.

Copyright © 2012 Wiley Periodicals, Inc.

KEYWORDS:

chemotherapy; leptomeningeal carcinomatosis; radiation; sinonasal undifferentiated carcinoma (SNUC)

PMID:
23471826
[PubMed - indexed for MEDLINE]
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