Rhinal Snuff: A Possible Gateway for Sinonasal Malignancy

Aim: To present a case report of malignancy of maxillary antrum invading the oral cavity associated with the habit of nasal snuff.

Presentation of Case: We describe here a case of a 40-year-old man who developed malignancy of maxillary antrum invading the hard palate after 20 years of snuff usage. He reported to our Department with the chief complaint of swelling and nasal discharge from right nostril since 4 months. On further questioning, patient revealed that he noticed swelling on the right middle 1/3rd of the face along with clear watery discharge from right nostril. Simultaneously, he also noticed a small pea sized swelling on the surface of hard palate which was gradual in onset and progressed to attain the present size.

Discussion: Use of smokeless tobacco products is common worldwide, with its increasing consumption in the developing countries and nasal snuff being the primeval form. Malignancy of the maxillary antrum is an uncommon neoplasm with a small percentage of occurrences. Different studies revealed that continuous use of nasal snuff proved to be carcinogenic.

Conclusion: Malignancy of maxillary antrum is relatively uncommon and its treatment poses several challenges to the head and neck surgeons, radiotherapists and medical oncologists. Nasal snuff is a deleterious habit and its prolonged usage proves to be fatal to the patient’s life, as happened in this case. Hence the use of tobacco in any form should be condemned in the society.