Intestinal metaplasia (IM) of the sinonasal mucosa is a putative precursor lesion of sinonasal intestinal type adenocarcinoma (sITAC), a carcinoma associated with wood-dust exposure(1–5). In this article, we compare genomic alterations in matched IM and sITAC to substantiate this connection.

Case presentation: A 68-year-old man with a history of wood-dust exposure and one-month bloody nasal secretion was seen at his local hospital. A biopsy demonstrated poorly differentiated carcinoma with neuroendocrine features. Fine needle aspiration (FNA) from a slightly enlarged cervical lymph node was without metastatic tumor cells. On MRI, the tumor measured 38x33x37mm; no signs of lymph-node pathology were seen (T2N0M0). A tertiary center performed endoscopic surgery; perioperative frozen sections showed sITAC (margins were macroscopically free).