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Nasal-type Natural Killer/T-cell Lymphoma Occurring at the Site from Which a Sinonasal Inverted Papilloma was Previously Resected: A Rare Case Report

Nasal-type Natural Killer/T-cell Lymphoma Occurring at the Site from Which a Sinonasal Inverted Papilloma was Previously Resected: A Rare Case Report

Bo-Nien Chen

Journal Title:Acta Scientific Otolaryngology
Abstract


Objectives: Sinonasal inverted papillomas (SNIPs) are benign and account for 0.5%-7% of sinonasal tumors. However, SNIPs have the potential for recurrence and malignant transformation. The most common histologic type of malignant transformation of SNIPs is squamous cell carcinoma, and it is rarely associated with other pathological types of malignancy. Herein, we present a unique case of nasal-type natural killer (NK)/T-cell lymphoma occurring at the site from which a SNIP was previously resected. Methods: A 58-year-old male nonsmoker had a left SNIP and underwent tumor excision by the endoscopic approach. Postopera- tively, SNIP recurrence was not observed in routine follow-up. Thirteen years later, at the age of 71 years, he reported blood-tinged discharge from the left nose for 1 month and was diagnosed with nasal-type NK/T-cell lymphoma occurring at the site from which the SNIP was previously resected. He subsequently underwent tumor excision by the endoscopic approach and adjuvant concurrent chemoradiotherapy (CCRT). Results: The patient tolerated treatment for nasal-type NK/T-cell lymphoma well. Recurrence of nasal-type NK/T-cell lymphoma was not observed during 30 months of follow-up after therapy. Conclusion: Based on our research, this is the first reported case of nasal-type NK/T-cell lymphoma occurring at the site from which a SNIP was previously resected. In this case, awareness and early diagnosis, followed by endoscopic excision and adjuvant CCRT, provided good treatment results. This report expands the spectrum of reported SNIP-associated malignancy and emphasizes the importance of considering the malignant transformation of SNIPs and close, prolonged (preferably life-long) follow-up. Keywords: Nasal-type Natural Killer/T-cell Lymphoma; Sinonasal Inverted Papilloma; Endoscopic Surgery; Concurrent Chemora- diotherapy