Primary Squamous Cell Carcinoma of the Nasal Floor: A Rare Subsite Presentation with Diagnostic and Reconstructive Challenges

Abstract

Sinonasal malignancies are rare, accounting for less than 1% of all cancers and approximately 3–5% of head and neck malignancies¹,². Among these, squamous cell carcinoma (SCC) is the most common histological subtype³. However, primary involvement of the nasal floor represents an exceptionally uncommon subsite with limited representation in published series.
We report a case of a 68-year-old male presenting with nonspecific nasal symptoms, ultimately diagnosed with keratinizing SCC arising from the nasal floor. The disease demonstrated early structural destruction despite localized radiological staging. The patient underwent wide local excision with immediate reconstruction followed by adjuvant radiotherapy, achieving good oncological control and acceptable cosmetic outcome.
A structured review of available literature highlights the scarcity of reported nasal floor SCC cases and underscores the diagnostic challenges associated with this entity. This case emphasizes the need for heightened clinical suspicion, early biopsy, and individualized multidisciplinary management. The limitations of current staging systems in addressing subsite-specific morbidity are discussed as a potential area for future research.