Sinonasal Undifferentiated Carcinoma with Intracranial Extension

Sinonasal undifferentiated carcinoma (SNUC) is a rare malignancy of the paranasal sinuses and considered by some to be uniformly fatal. At the UCDMC Center for Skull Base Surgery, over the past 15 years we have had experience with 13 such tumors. Most tumors arose in the ethmoid sinuses. All but 1 had a combined intracranial-extracranial resection through the anterior fossa-transcranial route and postoperative irradiation. The thirteenth patient had a transfacial subcranial approach. There are 4 who have survived free of disease at 14 years to 8 months of follow-up. The average follow-up was 6 years, 3 months. One patient died of a pulmonary embolism in the first postoperative week; a second died of a bowel infarction 3 months postoperatively. Three patients died of their disease at 20, 18, and 8 months postoperatively: 1 with local recurrence and distant metastasis and the other 2 with local control but distant disease. The 3 survivors are at 32, 48, and 192 months.