A 55-year-old male former woodworker presents with unilateral nasal obstruction, bloody discharge, and CT showing a mass in the ethmoid sinus with bone erosion. Histology reveals papillary structures lined by a mixture of squamous and columnar cells with mitoses. This occupational malignancy is most likely:
- A Inverted papilloma with malignant transformation
- B Adenocarcinoma of the ethmoid sinus ✓
- C Esthesioneuroblastoma (olfactory neuroblastoma)
- D Squamous cell carcinoma of the nasal cavity
Correct answer: B. Adenocarcinoma of the ethmoid sinus
Explanation
Adenocarcinoma of the ethmoid sinus is the classic occupational malignancy of woodworkers and leather workers due to exposure to wood dust (hardwood) and leather dust. The Stonebridge registry and European studies identified this association. Histologically it resembles intestinal-type adenocarcinoma (papillary, colonic pattern). This is a WHO-recognized occupational carcinogen. Inverted papilloma may undergo malignant transformation but lacks this occupational link. Esthesioneuroblastoma is neuroendocrine; SCC is squamous-lined.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.