Adenocarcinoma nasosinusal en Cantabria

Objective: Nasosinusal adenocarcinoma (NSADC) is an infrequent neoplasm with a strong association to occupational exposure to wood dust that is listed in the RD 1299/ 2006 occupational disease list. The purpose of this work is to know the incidence, the clinical characteristics and its declaration as an occupational disease in the Autonomous Community of Cantabria of Spain. Material and Method: Retrospective clinical-epidemiological study of patients diagnosed with NSADC in the autonomous community of Cantabria between the years 1990-2014. Results: During the study period, 36 cases of ADCNS were recorded. All cases were male, with a median age of 69 years. The most frequent location was the ethmoid. The main symptoms that motivated the specialist visit were nasal obstruction and epistaxis, with a median time until the first specialist visit of 6 months. Estimated survival at 5 years was 52%; 95% confidence interval (IC): 36-68%. In 31 patients (86%) there was an occupational history of occupations related to exposure to wood dust, with cabinetmakers and carpenters being the most frequent. However, no case was declared as an occupational contingency, and especially not as an occupational disease after the approval in 2006 of the current regulations. Conclusions: Clinical symptoms such as nasal obstruction or epistaxis should alert us in workers who have a history of working with wood. Most adenocarcinomas are diagnosed in advanced stages which worsens the prognosis. Adequate training and awareness of occupational cancer should be provided to physicians for better reporting of suspected occupational origin.