Sinonasal intestinal-type adenocarcinoma in northern Portugal: a woodworker's occupational hazard

Background Sinonasal carcinomas (SNC) constitute about 3% of all head and neck carcinomas, squamous cell carcinoma being the most common histologic subtype. Some geographical patterns in incidence are observed, as occupational exposure to wood dust is associated with intestinal-type adenocarcinoma (ITAC).Aims This study aims to describe the prevalence and characteristics of sinonasal ITAC cases in a region of northern Portugal with a robust wood industry.Methods A retrospective study of all sinonasal malignancies diagnosed over 5 years, in a tertiary hospital, primarily focused on ITAC subtypes. Data on sociodemographic and clinical variables were collected through electronic medical records and telephonic assessments.Results Of all 33 cases, 85% were ITAC. ITAC predominantly affected males (96%) with a mean age of 66.2 years. Most patients diagnosed with sinonasal ITAC had occupational wood dust exposure (96%), particularly to hardwoods. Initial symptoms included unilateral nasal obstruction (75%) and epistaxis (71%). Despite a median time of 3 months from symptoms to consultation, 50% presented at an advanced stage, with a 29% mortality rate.Conclusions Sinonasal ITAC is an occupational hazard of woodworkers and represents the vast majority of SNC in the region. This study advocates for targeted community interventions, emphasizing occupational safety measures and healthcare awareness to reduce morbimortality associated with this occupational cancer. This article examines the association between occupational exposure to wood dust and the incidence of sinonasal intestinal-type adenocarcinoma (ITAC), a rare form of head and neck cancer that predominantly affects woodworkers. By conducting a study in a region with a significant wood industry, this research further substantiates this association and underscores the necessity for targeted community interventions. These interventions aim to raise disease awareness and emphasize the importance of occupational safety measures for this population.