Oncocytoma of Maxillary Sinus- a rare presentation Prakash Adhikari, Rabindra Bhakta Pradhananga, Bimal Kumar Sinha, Bibhu Pradhan and Narmaya Thapa Department of Otorhinolaryngology and Head and Neck Surgery, T.U.Teaching Hospital, Kathmandu, Nepal Corresponding author: Dr.Prakash Adhikari, MBBS, Medical Officer, Department of Otorhino-Laryngology and Head and Neck Surgery, T.U.Teaching Hospital, Kathmandu, Nepal,Tel:+977-1-4414191,Fax:+977-1-4414191 e-mail:prakash_ooz@hotmail.com ABSTRACT A case of Oncocytoma of maxillary sinus in a 73 years old female is reported along with a brief review of literature. To the best of our knowledge this extremely rare tumor is the first of its kind reported in Nepal. Literature review has revealed only four such cases originating from maxillary sinus. Keywords: Oncocytoma, oxyphil cell adenoma, maxillary sinus. INTRODUCTION Oncocytoma, also known as Oxyphil cell adenoma is said to occur almost exclusively within the parotid gland which accounts for less than 1.0% of all salivary gland neoplasms. 1-4 It is a rare epithelial tumor, usually benign originating from the striated duct cells (oncocytes). 3-7 They are also found in pancreas, respiratory tract, thyroid, pituitary, parathyroid, adrenal glands and kidney. The gender distribution is almost equal. Even though few cases of nasal cavity oncocytomas have been reported in literature, its occurrence in maxillary sinus is extremely rare. To the best of our knowledge, this is the first case reported in Nepal. The malignant variants of oncocytomas are exceedingly rare. CASE REPORT A 73 years old female was admitted with a chief complaint of swelling of her right cheek for last 7 months. It was insidious in onset, gradually progressive and was associated with mild pain and discomfort. There was also history of epiphora from her right eye. There was no history of nasal obstruction, epistaxis, trismus, neurological or visual disturbances or proptosis. Past history was not significant. She was a smoker. On examination, her general condition was fair. There was no lymph node enlargement. Her respiratory, cardiovascular as well as abdomenopelvic examinations were within normal limits. On local examination there was a smooth & diffuse swelling measuring approximately 4cm x 5 cm over her right cheek which was firm and tender. Anterior rhinoscopic examination revealed a small fleshy mass present in her right middle meatus. The mass was insensitive to touch and was not friable. Her baseline investigations were all within normal limits. X-ray Para Nasal Sinus – Occipitomental view revealed homogenous opacity of her right maxillary antrum with expansion of all its walls. CT-Scan of nose and paranasal sinuses (3mm axial and coronal cuts) showed a well encapsulated heterogenous mass occupying the right nasal cavity and maxillary antrum with partial bony destruction of the floor, roof and medial walls. The mass was also extending to the anterior ethmoidal sinus of the same side. The nasal septum was pushed to the opposite side (Fig: 1). Biopsy was done under local anesthesia. Tissue samples were taken from the right middle meatus and also from maxillary antrum which was reported as oncocytoma.