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Diffuse spinal cord metastasis after resection of SMARCB1 sinonasal carcinoma manifesting with a right foot drop—a case report

Abstract

Introduction

The sinonasal carcinoma are rare tumors of the head and neck. The undifferentiated sinonasal carcinoma subtypes are constantly being explored and new mutations, with different prognosis markers and biological behaviors are being described. The SMARCB1 negative sinonasal carcinoma subtypes have been recently described with few reports of leptomeningeal and spinal cord invasion.

Case presentation

This study presents the case of a 59-year-old woman, with no previous disease, presenting initially with epistaxis that evolved to cranial nerve deficits and a left eye complete oftalmoplegia. After diagnostic investigation, she had a diagnosis of a left ethmoid sinus sinonasal carcinoma. Following resection of the tumor, she evolved with a right foot drop that eventually has been linked to diffuse spinal cord impairment. The histopathological diagnosis confirmed a SMARCB1 negative sinonasal carcinoma. Due to the diffuse metastasis, she underwent palliative care and died eight months after the surgery.

Discussion

Spinal cord metastasis may manifest with different clinical signs. Our case shows a rare manifestation of SMARCB1-deficient sinonasal carcinoma, a new subtype of sinonasal carcinoma, summarizing the importance of a high grade of suspicion of spinal cord invasion on these patients. SMARCB1 sinonasal carcinomas are rare new tumors of the head and neck, whose biological behaviors are yet to be explored. To the best of our knowledge, this is one of the few case reports describing simultaneous spread of this tumor to the central nervous system and spinal cord.

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Fig. 1: Pre procedure Magnetic Resonance Imaging.
Fig. 2: Histopathological analysis.
Fig. 3: Spinal cord metastasis.

Data availability

Data availability is found within the published article and its supplementary files. Additional data are available from the corresponding author on reasonable request.

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Acknowledgements

I thank Dr. Alex Machado Baeta and Dr. Hennan Salzedas Teixeira for their valuable inputs on my study. And the patient and her family for their dedication.

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Authors

Contributions

MAS was responsible for reviewing the protocol and writing the report. RGL was responsible for extracting and analyzing data. HST was responsible for reviewing and orientating the report. BMC was responsible for extracting and analyzing data. VMB contributed to data extraction. WSMF was responsible for extracting and analyzing data. CMSC was responsible for radiological orientation. MRN was responsible for neurosurgical orientation. AMB was responsible for reviewing and orientating the report.

Corresponding author

Correspondence to Matheus Alves da Silva.

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Competing interests

The authors declare no competing interests.

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Ethical approval was not required, we had patient and familiar authorization to use these data.

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da Silva, M.A., Bentes, R.G.L., Teixeira, H.S. et al. Diffuse spinal cord metastasis after resection of SMARCB1 sinonasal carcinoma manifesting with a right foot drop—a case report. Spinal Cord Ser Cases 8, 64 (2022). https://doi.org/10.1038/s41394-022-00532-8

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  • DOI: https://doi.org/10.1038/s41394-022-00532-8

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