Sinonasal undifferentiated carcinoma (SNUC) is a rare tumor that typically presents with nonspecific symptoms such as epistaxis, nasal obstruction, headache and facial pain. We report an atypical presentation of this neoplasm. Due to the non-specificity of the symptoms and to the fact that SNUC is a highly aggressive tumor, up to 70-90% of patients present with stage T4 disease and overall mortality is high. The purpose of this paper is to alert about an atypical presentation of this tumor and to reinforce the importance of a complete and correct patient evaluation in order to avoid future misdiagnosis. The obvious consequence is an advanced local disease at presentation with a poor prognosis.