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[Three cases of primary squamous cell carcinoma in the frontal sinus].

OBJECTIVE
Three cases of primary squamous cell carcinoma in the frontal sinus were reported, and the experience obtained from diagnosis, treatment of this rarely seen tumor was presented.


METHODS
Between August 2006 and January 2010, 3 cases of primary squamous cell carcinoma in the frontal sinus were diagnosed and treated including one case of basaloid squamous carcinoma, one moderately differentiated squamous cell carcinoma and one papillary squamous cell carcinoma. All 3 cases were treated with a combined approach using the endoscope and a frontal craniotomy, followed by radiotherapy and chemotherapy.


RESULTS
Case one developed multiple metastatic carcinoma lesions along the coronal incision inside the hairline. She received radiotherapy and chemotherapy, but died 16 months after surgery. Case 2 was found to have tumor recurrence in the left frontal sinus and orbit 40 days after surgery during his course of radiotherapy. Salvage surgery (orbital exoneration and tumor resection) was performed and radiotherapy and chemotherapy continued. Three months later, he was found to have bone metastasis and died 10 months after the first surgery. The third case developed orbital apex syndrome and loss of vision on the right side immediately after surgery. Fourteen months after surgery and radiotherapy, she was found to have tumor recurrence in the frontal sinus with intracranial invasion. She refused a second surgical procedure and is still alive with tumor 21 months after her operation.


CONCLUSIONS
The prognosis for patients with frontal sinus carcinoma remains extremely poor. Early detection and extended surgical resection combined with radiotherapy and chemotherapy are needed to improve the survival rates of patients with frontal sinus carcinoma.