鼻副鼻腔腺癌―WHO 分類による診断と治療 自験例の経験を含めて―

In Japan, sinonasal cancer is estimated to account for about 8% of all cases of head and neck cancer. While sinonasal adenocarcinoma accounts for about 10%-50% of all cases of sinonasal carcinoma in western countries, this percentage is lower in Japan. According to the WHO classification of 2017, sinonasal adenocarcinoma is categorized into intestinal and non-intestinal types. Intestinal-type adenocarcinoma (ITAC) is associated with wood and leather dust exposure, whereas non-intestinal type adenocarcinoma (non-ITAC) is not known to be associated with any environmental factors. Non-ITAC is further divided into low-grade (LG) non-ITAC and high-grade (HG) non-ITAC. Surgery followed by radiotherapy is considered to represent the gold standard for the management of sinonasal adenocarcinoma. In order to improve the local control and preserve organ function, some centers have explored the addition of chemotherapy to the aforementioned standard treatment strategy. Recently, the usefulness of concurrent chemoradiotherapy for squamous cell carcinoma and malignant melanoma of the sinonasal region was demonstrated; however, little is known yet about the usefulness of this strategy for cases of sinonasal non-ITAC. Herein, we describe the case of a patient with primary, locally advanced sinonasal non-ITAC who was successfully treated by intra-arterial cisplatin (CDDP) with concurrent radiotherapy.