Abstract: Sinonasal Undifferentiated Carcinoma in an 81-Year-Old Male with Visual Changes: A Case Report.

Authors

Cole Knoblich, Brant Hannahs, Matthew Schmitz, William C Spanos

Published in

South Dakota medicine : the journal of the South Dakota State Medical Association. Volume 79. Issue suppl 5. Pages s32-s33.

Abstract

Sinonasal undifferentiated carcinoma (SNUC) is a rare but aggressive malignancy of the sinonasal cavity that can present with nonspecific symptoms such as nasal congestion and epistaxis. These are common primary care complaints and resemble several benign diseases, often leading to delayed diagnosis. We present an advanced case of SNUC in a patient with progressive nasal obstruction and new-onset vision changes to highlight concerning features that warrant urgent evaluation.
We present an 81-year-old male with a history of nasal polyps that presented with a two-year history of unilateral nasal congestion and intermittent left-side epistaxis. Symptoms progressively worsened and were accompanied by new-onset blurred vision in the left eye, headache, imbalance, and facial pressure. His physical exam was unremarkable on external inspection. CT and MRI were significant for an expansile mass in the left ethmoid air cells with erosion of the cribriform plate, extension into the anterior cranial fossa, and invasion of the extraconal orbital space. There were no concerns for distant metastases based on chest imaging. Endoscopic biopsy revealed poorly differentiated carcinoma consistent with SNUC. He was started on chemotherapy and follow up at one month showed significant clinical and radiographic response, including return of baseline vision.
Patients with SNUC can present with vague symptoms mimicking sinusitis, often leading to delayed diagnosis. High risk symptoms such as persistent unilateral nasal obstruction, recurrent epistaxis, new-onset visual changes, or neurological symptoms warrant early imaging and specialist referral. Sinonasal malignancies should be included in the differential when high risk symptoms are present or not responding to medical management. Despite its rarity, SNUC is highly aggressive and tends to invade nearby structures at presentation. Primary care clinicians serve a critical role in early recognition of alarming features to promote timely diagnosis and multidisciplinary management, which may improve patient outcomes.

PMID:
42525999
Bibliographic data and abstract were imported from PubMed on 30 Jul 2026.

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