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Carcinoma of the Nasal Vestibule

Aizaz Tariq, G Davidov, Lilyana Petkova, Nikolay Sapundzhiev

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Abstract

Introduction: Carcinoma of the nasal vestibule (CNV) is one of the rarest cancers of the head and neck. The nasal vestibule is the gateway to the nasal cavity, it is lined by stratified squamous epithelium and contains structures such as hair follicles, sweat and sebaceous glands. Therefore, it is not unexpected that a tumor can possibly develop from the nasal vestibule. Furthermore, it has different etiology, staging and treatment strategies compared with tumors arising from the nasal cavity. An example of squamous cell carcinoma of the nasal vestibule is reported. Materials and Methods: A 65-year-old man who had been a smoker for 30 years presented with an unclarified tumor in the left nostril. Chief complaints included a lesion in the left nostril, which had been treated with a type of local medication for a year without any success. Biopsy revealed carcinoma of the nasal vestibule. PET-CT revealed no regional or distal involvement. Because of concomitant diabetic retinopathy and impaired vision, the patient refused radiotherapy. He underwent subtotal rhinectomy. Complementary resection of the septum was needed at the second stage because of one positive resection margin. Results: No postoperative complications or recurrences were encountered during a follow-up period of six months. The patient was further subjected to reconstructive surgery with an oblique frontal flap. Conclusion: Surgical treatment of carcinoma of the nasal vestibule is reserved for the management of residual or metastatic cancer or in cases with contraindications to radiotherapy. Due to the anatomical location of the tumor the symptoms can include nasal obstruction, epistaxis and pain although sometimes not all the symptoms are seen in patients and some patients might not have any symptoms at all.

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Introduction: Carcinoma of the nasal vestibule (CNV) is one of the rarest cancers of the head and neck. The nasal vestibule is the gateway to the nasal cavity, it is lined by stratified squamous epithelium and contains structures such as hair follicles, sweat and sebaceous glands. Therefore, it is not unexpected that a tumor can possibly develop from the nasal vestibule. Furthermore, it has different etiology, staging and treatment strategies compared with tumors arising from the nasal cavity. An example of squamous cell carcinoma of the nasal vestibule is reported. Materials and Methods: A 65-year-old man who had been a smoker for 30 years presented with an unclarified tumor in the left nostril. Chief complaints included a lesion in the left nostril, which had been treated with a type of local medication for a year without any success. Biopsy revealed carcinoma of the nasal vestibule. PET-CT revealed no regional or distal involvement. Because of concomitant diabetic retinopathy and impaired vision, the patient refused radiotherapy. He underwent subtotal rhinectomy. Complementary resection of the septum was needed at the second stage because of one positive resection margin. Results: No postoperative complications or recurrences were encountered during a follow-up period of six months. The patient was further subjected to reconstructive surgery with an oblique frontal flap. Conclusion: Surgical treatment of carcinoma of the nasal vestibule is reserved for the management of residual or metastatic cancer or in cases with contraindications to radiotherapy. Due to the anatomical location of the tumor the symptoms can include nasal obstruction, epistaxis and pain although sometimes not all the symptoms are seen in patients and some patients might not have any symptoms at all.

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Available abstract

Introduction: Carcinoma of the nasal vestibule (CNV) is one of the rarest cancers of the head and neck. The nasal vestibule is the gateway to the nasal cavity, it is lined by stratified squamous epithelium and contains structures such as hair follicles, sweat and sebaceous glands. Therefore, it is not unexpected that a tumor can possibly develop from the nasal vestibule. Furthermore, it has different etiology, staging and treatment strategies compared with tumors arising from the nasal cavity. An example of squamous cell carcinoma of the nasal vestibule is reported. Materials and Methods: A 65-year-old man who had been a smoker for 30 years presented with an unclarified tumor in the left nostril. Chief complaints included a lesion in the left nostril, which had been treated with a type of local medication for a year without any success. Biopsy revealed carcinoma of the nasal vestibule. PET-CT revealed no regional or distal involvement. Because of concomitant diabetic retinopathy and impaired vision, the patient refused radiotherapy. He underwent subtotal rhinectomy. Complementary resection of the septum was needed at the second stage because of one positive resection margin. Results: No postoperative complications or recurrences were encountered during a follow-up period of six months. The patient was further subjected to reconstructive surgery with an oblique frontal flap. Conclusion: Surgical treatment of carcinoma of the nasal vestibule is reserved for the management of residual or metastatic cancer or in cases with contraindications to radiotherapy. Due to the anatomical location of the tumor the symptoms can include nasal obstruction, epistaxis and pain although sometimes not all the symptoms are seen in patients and some patients might not have any symptoms at all.

Key concepts: Nasal vestibule, Medicine, Nostril, Vestibule, Nasal cavity, Surgery, Nose, Radiation therapy

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