Four cases of small cell carcinoma of the sinonasal cavity

We report four cases of small cell carcinoma of the sinonasal cavity. The primary sites were the ethmoidal sinonasal cavity in two cases and maxillary sinonasal cavity in two cases. In three of the four cases, chemoradiotherapy was planned, because the cancers were locally advanced, with the tumor size and extent exceeding T3. One of these patients died of an adverse event during the chemoradiotherapy with cisplatin (CDDP) and irinotecan (CPT-11). In another, metastases in the liver and ileum were detected after the chemoradiotherapy with CDDP and etoposide (VP-16), and the patient died 22 months after her initial visit. In the third case, no evidence of recurrence or metastasis was detected until 20 months after completion of the chemoradiotherapy with the carboplatin (CBDCA) and VP-16. In the one case with multiple distant metastases at presentation, six courses of chemotherapy with CBDCA and VP-16 were administered, however, the patient died six months after her initial visit. Because small cell carcinoma of the sinonasal cavity is very rare, no standard treatment has been established yet. In most previously reported cases, chemoradiotherapy was selected because operation was not possible due to the tumor invasion to surrounding organs and the sensitivity to radiation was good. Patients reported here who completed chemoradiotherapy showed good local control. However, the prognosis of small cell carcinoma of the sinonasal cavity is poor and strict surveillance for recurrence and metastasis is needed after treatment.