case_images: PMC7265421_01
case_images: CT image (coronal and axial) of a 27-year-old male found to have a mixed olfactory neuroblastoma and carcinoma. Tumor appears to fill the right nasal cavity and extend into the right maxillary sinus, with erosion of bone and ethmoid air cells on the right.
case_images: SNI-11-97-g001.jpg
case_images: PMC7265421_01_SNI-11-97-g001.jpg
case_images: F1
case_images: There was near total opacification of the right frontal sinus, maxillary sinus, and ethmoid air cells with right preseptal soft-tissue edema [Figure 1].
case_images: (a) CK7 highlights the glandular component x200, (b) Cytologically the majority of cells have high nuclear to cytoplasmic ratios coarse chromatin and display frequent mitoses and apoptotic bodies H&E x400, (c) Glandular component corresponding to CK7 image H&E x200, (d) Glandular component merging into poorly differentiated carcinoma H&E x200, (e) Neuroblastoma component with neuropil formation H&E x400, (f) p40 is positive in a subset of cells and is negative in glandular and neuroblastoma components x200, (g) S100 is positive mainly at the periphery of nests x100, (h) Squamous component with single cell keratinization H&E x400, (i) Synaptophysin is positive in majority of cells x200.
case_images: SNI-11-97-g002.jpg
case_images: PMC7265421_01_SNI-11-97-g002.jpg
case_images: F2
case_images: Unexpectedly, the pathology from the right maxilla revealed a high grade malignant neoplasm, most consistent immunophenotypically and histologically with high grade "mixed" ONB and carcinoma [Figure 2]. Immunohistochemical staining of the tumor showed positivity for the following markers, which differed slightly depending on the area of tumor that was stained: synaptophysin, CD56, chromogranin (rare/focal), S100 peripherally, Pan CK, CAM 5.2, CK7, p16, p63, CK 5/6, and p40 [Table 1, Figure 2].