One Tumour, Biphasic Morphology: A Case Series of HPV-related Multiphenotypic Sinonasal Carcinoma and Diagnostic Schema
Keywords:
Biphasic morphology, Case series, Diagnostic schema, HPV-related, Multiphenotypic, Sinonasal carcinomaAbstract
Human papillomavirus (HPV)-related multiphenotypic sinonasal carcinoma (HMSC) is a rare malignancy displaying a biphasic histomorphology that mimics both conventional squamous cell carcinoma and true salivary adenoid cystic carcinoma, frequently leading to diagnostic confusion with these distinct entities. Herein, we present two clinical cases sharing a common histomorphological signature: a 56-year-old male presenting with an aggressive left sinonasal mass invading the orbital floor with intracranial extension of 3 months' duration, and a 65-year-old female with a destructive left external nasal mass of 2 years' duration masquerading as granulomatosis with polyangiitis. Histopathological evaluation confirmed HPV-related multiphenotypic sinonasal carcinoma in both cases, identifying the pathognomonic transition. Following confirmation, entirely non-surgical management was pursued; the first patient was commenced on a six-month chemotherapy course followed by radiotherapy, while the second patient is currently on follow-up awaiting chemotherapy. Ultimately, diagnostic precision hinges on identifying this distinct biphasic architectural pattern on routine microscopy, a prerequisite for distinguishing HMSC from its mimics.
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