Background: Sinonasal malignancies are a rare and heterogeneous group of neoplasms, the primary
treatment of which has traditionally involved surgical resection. However, recent
studies on sinonasal undifferentiated carcinoma have demonstrated survival benefit
with the use of induction chemotherapy as a marker of biologic behavior and treatment
decision-making. The use of such an approach has been explored with other sinonasal
malignancies as a potential alternative to surgical resection, especially in patients
with extensive disease. However, such a protocol may be less effective for certain
etiologies, especially those of neuroendocrine origin. Literature on small cell lung
cancer has shown that induction chemotherapy and definitive chemoradiation may be
associated with rapid recurrence, and may be inferior to upfront surgical resection.
Methods: We present a literature review and a three patient case series with undifferentiated
sinonasal neuroendocrine carcinoma that were all treated with induction chemotherapy
and subsequent chemoradiation.
Result: All three patients experienced a significant reduction in their disease burden with
induction chemotherapy, but unfortunately every patient has a subsequent extensive
recurrence of their carcinoma, with two patients ultimately succumbing to the malignancy.
Conclusion: This review of the literature and case series serves to demonstrate while induction
chemotherapy and definitive chemoradiation has changed the treatment paradigm with
SNUC, primary surgical resection with adjuvant therapy should be consider for sinonasal
neuroendocrine carcinoma when R0 resection is feasible.
