Case report: Immoderate perfume use leading to non-keratinising sinonasal squamous cell carcinoma with bone and lung metastases Authors Shamail Zia Department of Pathology, Noor e Zia Consultant Teleclinics, Karachi, Pakistan Farozaan Shamail Department of Family Medicine, Noor e Zia Consultant Teleclinics, Karachi, Pakistan Fazail Zia Department of Pathology, Noor e Zia Consultant Teleclinics, Karachi, Pakistan Naeem Uddin Department of Family Medicine, Noor e Zia Consultant Teleclinics, Karachi, Pakistan Vardah Zia Department of Family Medicine, Noor e Zia Consultant Teleclinics, Karachi, Pakistan Shamsa Naeem Department of Family Medicine, Noor e Zia Consultant Teleclinics, Karachi, Pakistan DOI: https://doi.org/10.47391/JPMA.23051 Keywords: Perfume, Nasal Cavity, Squamous cell carcinoma, Sinonasal cancer, Bone metastases, Lung metastases Abstract Squamous cell carcinoma (SCC) of the sinonasal tract (SNSCC) is a cancerous epithelial tumour which originates from the epithelium surface lining the nasal cavity and paranasal sinuses and shows squamous differentiation. Here, we report the case of a patient who had the habit of soaking cotton cloth at night with perfume and spreading it over his face and sleeping for around eight hours in this position. The patient had been doing this for 30 years without any gap and presented with complaints of nose bleed and difficulty in breathing since three to four months. Upon scanning of the face, a polypoidal lesion was seen in the left nasal cavity causing partial obstruction of the nasal cavity. Biopsy of the nasal mass confirmed the presence of neoplastic lesions positive for cytokeratin 5/6 diagnosed as non-keratinising SCC. Upon further evaluation of symptoms, metastases in bones and lungs were also confirmed. Keywords: Nasal cavity, Paranasal sinuses, Perfume, Carcinoma, Keratin-5. Downloads Full Text Article Published 2026-04-20 How to Cite Zia, S., Shamail, F., Zia, F., Uddin, N., Zia, V., & Naeem, S. (2026). Case report: Immoderate perfume use leading to non-keratinising sinonasal squamous cell carcinoma with bone and lung metastases. Journal of the Pakistan Medical Association, 76(05), 771–774. https://doi.org/10.47391/JPMA.23051 More Citation Formats ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver Download Citation Endnote/Zotero/Mendeley (RIS) BibTeX Issue Vol. 76 No. 05 (2026): MAY Section CASE REPORT License Copyright (c) 2026 Journal of the Pakistan Medical Association This work is licensed under a Creative Commons Attribution 4.0 International License.