Rare naso-sinonasal lesions represent a diagnostic challenge for clinicians because of the paucity of the cases and similarities with other more frequently sinonasal pathologies. The aim of the study was to present five rare sinonasal lesions in order to emphasize their symptomatology, imaging aspects, histopathological features, algorithms of diagnosis, and strategies of treatment and importance of teamwork between clinicians, pathologists and radiologists for a correct and prompt diagnosis.
Case presentations: The cases were represented by patients with nasal sarcoidosis, nasal primitive neuroectodermal tumors, sinonasal mucosal melanoma, sinonasal plasmacytomas and nasal-type extranodal natural killer (NK) T-cell lymphoma. All the patients were biopsied in the Department of ENT (Ear, Nose and Throat), "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania, and the diagnosis was made using routine and immunohistochemical (IHC) stainings. The patients with sinonasal melanoma and the patient with extranodal NK T-cell lymphoma died in few months after diagnosis, despite treatment. Rare sinonasal lesions share similar symptomatology and imaging aspects with other, more frequently diagnosed entities. The cases reported in this paper showed the same pattern as those presented in other studies; the symptomatology, diagnosis, treatment and prognosis were the same. Clinical examination, imaging studies and routine and IHC markers guides us to the right diagnosis that should be prompt because of the prognosis of some tumors. The treatment has a few characteristics: surgery excision within safe margins, working with other specialties (oncology, radiotherapy, hematology, nephrology, pneumology), follow-up and correctly informing the patient being mandatory.
Conclusions: In this paper, there were presented five interesting cases of rare sinonasal lesions, in order to highlight the importance of teamwork for a quick and correct diagnosis.