The rarest of the rare, sinonasal tumours form only a small part of the total number of head and neck tumours and undifferentiated carcinoma (SNUC) is one of the rarest of this group. There is some data (and some expert opinion) that strongly advise against surgery as primary treatment and for a protocol that includes induction chemotherapy. This multicentre retrospective study provides some valuable data on the prognosis and treatment of this challenging tumour. Using the combined databases of most French cancer centres, the authors only managed to report on 54 patients. Most patients presented with advanced disease (which is expected) and patients who underwent surgery experienced more recurrence and higher mortality compared to those who received only concurrent chemoradiotherapy. Induction chemotherapy and IMRT seem to predict improved DFS; however, any role for surgical resection remains unclear. This article does show the way forward – only by combining databases can we hope to get enough data that will allow us to draw conclusions about these rare and challenging tumours.