Fraternal Coopers Develop Sinonasal Intestinal-Type Adenocarcinoma

Abstract We describe 2 brothers with a history of working in the family business of whiskey barrel making who both developed sinonasal intestinal-type adenocarcinomas (ITACs) around their seventh decade of life. This highlights the strong association of ITAC with occupational wood dust exposure, and the typical development of disease occurring around the sixth to seventh decade of life. Intestinal-type adenocarcinomas show morphologic and phenotypic similarities to their primary intestinal counterparts, particularly expression of CDX2 and CK20. Despite the morphologic and phenotypic similarities, the molecular alterations that are common to many adenocarcinomas of the intestinal tract are not present in ITAC. This description highlights the wide morphologic spectrum of ITAC and the often protracted course of this disease process.