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SMARCB1 (INI-1)-deficient Sinonasal Carcinoma: A Series of 39 Cases Expanding the Morphologic and Clinicopathologic Spectrum of a Recently Described Entity. Am J Surg Pathol 2017; 41:458-471. [PMID: 28291122 DOI: 10.1097/pas.0000000000000797] [Citation(s) in RCA: 159] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
To more fully characterize the clinical and pathologic spectrum of a recently described tumor entity of the sinonasal tract characterized by loss of nuclear expression of SMARCB1 (INI1), we analyzed 39 SMARCB1-deficient sinonasal carcinomas collected from multiple medical centers. The tumors affected 23 males and 16 females with an age range of 19 to 89 years (median, 52). All patients presented with locally advanced disease (T3, n=5; T4, n=27) involving the sinuses (mainly ethmoid) with variable involvement of the nasal cavity. Thirty patients received surgery and/or radiochemotherapy with curative intent. At last follow-up, 56% of patients died of disease 0 to 102 months after diagnosis (median, 15), 2 were alive with disease, and 1 died of an unrelated cause. Only 9 patients (30%) were alive without disease at last follow-up (range, 11 to 115 mo; median, 26). The original diagnosis of retrospectively identified cases was most often sinonasal undifferentiated carcinoma (n=14) and nonkeratinizing/basaloid squamous cell carcinoma (n=5). Histologically, most tumors displayed either a predominantly basaloid (61%) or plasmacytoid/rhabdoid morphology (36%). The plasmacytoid/rhabdoid form consisted of sheets of tumor cells with abundant, eccentrically placed eosinophilic cytoplasm, whereas similar cells were typically rare and singly distributed in the basaloid variant. Glandular differentiation was seen in a few tumors. None of the cases showed squamous differentiation or surface dysplasia. By immunohistochemistry, the tumors were positive for pancytokeratin (97%), CK5 (64%), p63 (55%), and CK7 (48%); and they were negative for NUT (0%). Epstein-Barr virus and high-risk human papillomavirus was not detected by in situ hybridization. Immunohistochemical loss of SMARCB1 (INI1) expression was confirmed for all 39 tumors. Investigation of other proteins in the SWI/SNF complex revealed co-loss of SMARCA2 in 4 cases, but none were SMARCA4 deficient or ARID1A deficient. Of 27 tumors with SMARCB1 fluorescence in situ hybridization analysis, 14 showed homozygous (biallelic) deletions and 7 showed heterozygous (monoallelic) deletions. SMARCB1-deficient sinonasal carcinoma represents an emerging poorly differentiated/undifferentiated sinonasal carcinoma that (1) cannot be better classified as another specific tumor type, (2) has consistent histopathologic findings (albeit with some variability) with varying proportions of plasmacytoid/rhabdoid cells, and (3) demonstrates an aggressive clinical course. This entity should be considered in any difficult-to-classify sinonasal carcinoma, as correct diagnosis will be mandatory for optimizing therapy and for further delineation of this likely underdiagnosed disease.
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López F, Grau JJ, Medina JA, Alobid I. Consenso español para el tratamiento de los tumores nasosinusales. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017; 68:226-234. [DOI: 10.1016/j.otorri.2016.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 07/22/2016] [Accepted: 07/27/2016] [Indexed: 12/25/2022]
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He N, Chen X, Zhang L, Chen X, Huang Z, Zhong Q, Ma H, Feng L, Hou L, Fang J. Minimally invasive endoscopic resection for the treatment of sinonasal malignancy: the outcomes and risk factors for recurrence. Ther Clin Risk Manag 2017; 13:593-602. [PMID: 28496329 PMCID: PMC5422458 DOI: 10.2147/tcrm.s131185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Purpose The role of minimally invasive endoscopic resection (MIER) in the treatment of sinonasal malignancy is controversial. Herein, we performed a retrospective review of a large case series of sinonasal malignancy patients treated with MIER aimed at evaluating the outcomes and identifying the risk factors for recurrence. Methods Patients with sinonasal malignancy who underwent MIER from March 2000 to May 2015 were enrolled, and their clinical data were collected. The clinical outcomes were evaluated by determining the 5-year overall survival (OS) and disease-free survival (DFS). The predictive factors for survival and potential independent risk factors for recurrence were explored. Results A total of 120 patients were enrolled, including 62 males and 58 females. The mean follow-up period was 51.4 (95% confidence interval: 44.0–59.1) months. The most frequent histological type was mucosal malignant melanoma. The positive margin rate was 19.2% (23/120). Seventy-one patients had the safety anatomic plane (SAP). Age ≥50 years, nodal metastasis, and not having the SAP were found to be predictive factors for survival, and absence of SAP was found to be an independent risk factor for recurrence. Conclusion Our study indicated that MIER is an effective and safe surgical procedure in appropriately selected patients. Tumor resection with a safety anatomic boundary is likely to lead to improved survival and decreased recurrence. However, a larger sample and long-term prospective observation are still required to establish the role of MIER in treatment of sinonasal malignancy.
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Affiliation(s)
- Ning He
- Department of Otolaryngology - Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University.,Key Laboratory of Otorhinolaryngology, Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing.,Department of Otolaryngology & Head and Neck Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Autonomous Region
| | - Xiaohong Chen
- Key Laboratory of Otorhinolaryngology, Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing
| | - Luo Zhang
- Key Laboratory of Otorhinolaryngology, Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing
| | - Xuejun Chen
- Key Laboratory of Otorhinolaryngology, Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing
| | - Zhigang Huang
- Key Laboratory of Otorhinolaryngology, Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing
| | - Qi Zhong
- Key Laboratory of Otorhinolaryngology, Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing
| | - Hongzhi Ma
- Key Laboratory of Otorhinolaryngology, Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing
| | - Ling Feng
- Key Laboratory of Otorhinolaryngology, Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing
| | - Lizhen Hou
- Key Laboratory of Otorhinolaryngology, Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing
| | - Jugao Fang
- Department of Otolaryngology - Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University.,Key Laboratory of Otorhinolaryngology, Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing.,Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing, People's Republic of China
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Maxfield AZ, Chambers KJ, Sedaghat AR, Lin DT, Gray ST. Mucosal Thickening Occurs in Contralateral Paranasal Sinuses following Sinonasal Malignancy Treatment. J Neurol Surg B Skull Base 2017; 78:331-336. [PMID: 28725520 DOI: 10.1055/s-0037-1598048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 12/09/2016] [Indexed: 02/03/2023] Open
Abstract
Objective To investigate the incidence and degree of contralateral sinus disease following treatment of sinonasal malignancy (SNM) using radiological findings as an outcome measure. Study Design Retrospective case series. Setting Tertiary referral academic center. Participants Patients with SNM treated with surgical and adjuvant radiotherapy with or without concurrent chemotherapy. Main Outcome Measures Pre- and posttreatment computed tomography and magnetic resonance imaging scans, Lund-Mackay (LM) score, date of diagnosis, chemotherapy, and dosage of radiation therapy (RT). Results There was a significant difference between pre- and posttreatment LM scores ( p < 0.001) of the contralateral paranasal sinuses. There was no statistical significance between the change in pre- and posttreatment LM scores and patient age, gender, chemotherapy, RT dosage, and time lapse between diagnosis and when we performed this study in the univariate and the multivariable analyses. Conclusions Following treatment of SNM with surgical resection and RT, there was a significant increase in incidence and degree of mucosal thickening of the contralateral sinus by LM grading that persisted after the completion of treatment. This indicates the need for long-term follow-up to monitor for chronic rhinosinusitis as a delayed complication following treatment of SNM.
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Affiliation(s)
- Alice Z Maxfield
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
| | - Kyle J Chambers
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
| | - Ahmad R Sedaghat
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
| | - Derrick T Lin
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
| | - Stacey T Gray
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
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Li L, Zhu L. Expression and clinical significance of TrkB in sinonasal squamous cell carcinoma: a pilot study. Int J Oral Maxillofac Surg 2016; 46:144-150. [PMID: 27810139 DOI: 10.1016/j.ijom.2016.09.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 07/17/2016] [Accepted: 09/30/2016] [Indexed: 12/19/2022]
Abstract
Previous studies have confirmed that tropomyosin-related kinase B (TrkB) plays a critical role in the occurrence, development, and metastasis of many kinds of malignant tumour. More recently, TrkB was found to be overexpressed in head and neck squamous cell carcinoma (SCC) and to be involved in multistep tumour progression. In this study, the expression of TrkB was investigated in 27 cases of sinonasal SCC using an immunohistochemical method. The clinical significance and possible role of TrkB as a prognostic marker in these tumours was also explored. The results showed that TrkB was overexpressed in all cases of sinonasal SCC. A high level of expression of TrkB was significantly related with poor-to-moderate differentiation of SCC (P=0.026), high clinical stage (P=0.023), and the presence of local recurrence (P=0.004). Analysis by Kaplan-Meier method indicated that patients with high levels of TrkB expression had shorter overall survival (P=0.006) and disease-free survival (P=0.018). Multivariate analysis revealed that the level of TrkB expression was an independent prognostic factor for both overall and disease-free survival (P=0.019 and P=0.048, respectively). These data suggest that the overexpression of TrkB may play a significant role in sinonasal SCC and that TrkB may be used as a potential prognostic marker for the clinical outcome.
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Affiliation(s)
- L Li
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, China
| | - L Zhu
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, China.
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Kim BS, Pak K, Yi KI, Kim IJ, Roh HJ, Cho KS. Prognostic value of tumoral heterogeneity and volumetric parameters as measured by F18-FDG PET/CT in sinonasal cancer. Eur Arch Otorhinolaryngol 2016; 274:1437-1443. [PMID: 27747383 DOI: 10.1007/s00405-016-4346-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 10/11/2016] [Indexed: 02/03/2023]
Abstract
The objective of this study was to investigate the value of parameters assessed with F18-FDG PET/CT in predicting recurrence-free survival (RFS) and disease-specific survival (DSS) in patients with cancer of nasal cavity and paranasal sinus. Thirty-eight patients with cancer of nasal cavity (n = 14) and paranasal sinus (n = 24) who underwent PET/CT prior to curative treatment were enrolled. A volume of interest was placed on PET/CT images covering the entire tumor volume, and the maximum SUV (SUVmax), the mean SUV (SUVmean), and volumetric parameters of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were measured using thresholds of 40 % of SUVmax. The heterogeneity factor (HF) defined as the derivative of volume-threshold function from 40 to 80 % of SUV thresholds. RFS and DSS were defined as the time from the diagnosis to recurrence and death. Median values of SUVmax, SUVmean, MTV, TLG, and HF were 14.81, 9.16, 25.84, 150.74, and -0.496. SUVmax was higher in patients with advanced stage and nodal metastasis. High MTV and low HF group showed shorter RFS. Cox proportional hazards regression analysis revealed low HF was the only significant predictive factor on RFS. Furthermore, high TLG was associated with shorter DSS. High TLG was potent predictor of DSS by Cox proportional hazards regression analysis. In conclusion, the tumoral heterogeneity and volumetric parameters as measured by F18-FDG PET/CT could be significant prognostic surrogate markers in patients with sinonasal cancer.
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Affiliation(s)
- Bum Soo Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Kyoungjune Pak
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Keun-Ik Yi
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, 179 Gudeok-Ro, Seo-gu, Busan, 602-739, Republic of Korea
| | - In Joo Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Hwan-Jung Roh
- Department of Otorhinolaryngology and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Kyu-Sup Cho
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, 179 Gudeok-Ro, Seo-gu, Busan, 602-739, Republic of Korea.
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Amsbaugh MJ, Yusuf M, Silverman C, Bumpous J, Perez CA, Potts K, Tennant P, Redman R, Dunlap N. Organ preservation with neoadjuvant chemoradiation in patients with orbit invasive sinonasal cancer otherwise requiring exenteration. Radiat Oncol J 2016; 34:209-215. [PMID: 27592515 PMCID: PMC5066443 DOI: 10.3857/roj.2016.01739] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 05/23/2016] [Accepted: 06/21/2016] [Indexed: 12/15/2022] Open
Abstract
Purpose We sought to determine if organ preservation (OP) with neoadjuvant chemoradiation (CRT) was feasible in patients with sinonasal cancer determined to require exenteration. Materials and Methods Twenty patients were determined to require exenteration for definitive treatment from 2005 to 2014. Fourteen patients underwent OP and 6 patients received exenteration with adjuvant CRT. Exenteration free survival (EFS), locoregional control (LRC), progression-free survival (PFS), and overall survival (OS) were estimated. Results Five patients (36%) receiving OP had complete disease response at time of surgery. With a median follow-up of 18.8 months, EFS was 62% at 2 years for patients undergoing OP. At 2 years, there were no significant differences in LRC, PFS or OS (all all p > 0.050) between the groups. Less grade 3 or greater toxicity was seen in patients undergoing OP (p = 0.003). Visual function was preserved in all patients undergoing OP. Conclusion For patients with sinonasal cancer, OP may avoid exenteration, offering similar disease control and improved toxicity.
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Affiliation(s)
- Mark J Amsbaugh
- Department of Radiation Oncology, University of Louisville, Louisville, KY, USA
| | - Mehran Yusuf
- Department of Radiation Oncology, University of Louisville, Louisville, KY, USA
| | - Craig Silverman
- Department of Radiation Oncology, University of Louisville, Louisville, KY, USA
| | - Jeffrey Bumpous
- Department of Otolaryngology, University of Louisville, Louisville, KY, USA
| | - Cesar A Perez
- Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Keven Potts
- Department of Otolaryngology, University of Louisville, Louisville, KY, USA
| | - Paul Tennant
- Department of Otolaryngology, University of Louisville, Louisville, KY, USA
| | - Rebecca Redman
- Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Neal Dunlap
- Department of Radiation Oncology, University of Louisville, Louisville, KY, USA
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Soberón GS, Prado HM, Sadek A, Plowes O, Arrieta JR, Figueroa V. Proposal for Staging of Inflammatory Lesions in the Frontal Region. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2016. [DOI: 10.1016/j.otoeng.2016.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Allison DB, Bishop JA, Ali SZ. Cytopathologic characteristics of SMARCB1 (INI-1) deficient sinonasal carcinoma: A potential diagnostic pitfall. Diagn Cytopathol 2016; 44:700-3. [PMID: 27177850 DOI: 10.1002/dc.23503] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 03/29/2016] [Accepted: 04/28/2016] [Indexed: 11/05/2022]
Abstract
Tumors of the head and neck are extremely diverse and a subset are poorly differentiated and difficult to classify. Recently, a new entity has been described with rhabdoid and/or plasmacytoid cytologic features and a characteristic genetic signature-inactivation of the SMARCB1 (INI-1) tumor suppressor gene. To date, only 16 cases of SMARCB1 (INI-1) deficient sinonasal carcinoma have been described, and there are currently no reports of the cytopathologic features by fine needle aspiration (FNA) cytology. A case of a 77-year-old man who presented with a posterior ethmoid sinus lesion with invasion into the skull base and bone was reported. FNA cytology of a right retropharyngeal lymph node revealed relatively monomorphic, loosely cohesive clusters of plasmacytoid cells with occasional nucleoli, rare intranuclear cytoplasmic inclusions, and mitotic figures in a background of necrosis and absence of overt squamous or glandular differentiation. A diagnosis of metastatic myoepithelial carcinoma was made; however, retrospectively, the surgical excision showed loss of the SMARCB1 (INI-1) tumor suppressor gene by immunohistochemistry. In summary, the cytomorphologic features of SMARCB1 (INI-1) deficient sinonasal carcinoma are relatively nonspecific and overlap with other regional tumors, including myoepithelial neoplasms. As a result, this entity should be considered in the differential diagnosis for a plasmacytoid tumor arising in the sinonasal tract by FNA cytology. Diagn. Cytopathol. 2016;44:700-703. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Derek B Allison
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Justin A Bishop
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Syed Z Ali
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
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Intensity modulated radiation therapy (IMRT) for sinonasal tumors: a single center long-term clinical analysis. Radiat Oncol 2016; 11:17. [PMID: 26847089 PMCID: PMC4743109 DOI: 10.1186/s13014-016-0595-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 01/29/2016] [Indexed: 01/25/2023] Open
Abstract
Background Radiotherapy has a central role in the treatment of sinonasal malignancies, either as postoperative or as primary therapy. To study the efficacy and safety of intensity modulated radiotherapy (IMRT) for sinonasal tumors a single center retrospective evaluation focusing on survival and therapy related toxicity was performed. Methods One hundred twenty two patients with primary (n = 82) or recurrent (n = 40) malignant sinonasal tumors were treated with intensity modulated radiotherapy between 1999 and 2009 at the University Clinic of Heidelberg and the German Cancer Research Center and retrospectively analyzed. Most patients had adenoid cystic carcinomas (n = 47) or squamous cell carcinoma (n = 26). 99 patients received postoperative radiotherapy. The median total dose was 64 Gy in conventional fractionation (1.8–2 Gy). Overall survival (OS), progression free survival (PFS) and local recurrence free survival (LRFS) rates were calculated using the Kaplan-Meier method. The log-rank test and Fishers Exact test were applied for univariate analysis, Cox-regression was used for multivariate analysis. Results Median follow up was 36 months. 1-, 3- and 5-year estimated overall survival rates were 90, 70 and 54 % respectively. Median progression free survival and local recurrence free survival was 45 and 63 months respectively. Progression free survival and local recurrence free survival at 1, 3 and 5 years were 76, 57 and 47, and 79, 60 and 51 % respectively. 19 patients (15.5 %) were diagnosed with distant metastases. Univariate analysis revealed significantly improved OS and LRFS for treatment of tumors after primary diagnosis, first series of irradiation and radiation dose ≥60 Gy. Multivariate analysis revealed only treatment in primary situation as an independent prognostic factor for OS and LRFS. Acute CTC grade III mucositis was seen in 5 patients (4.1 %) and CTC grade II dysgeusia in 19 patients (15.6 %). Dysgeusia, dysosmia and ocular toxicity were the most common late adverse events. Conclusions Our data support the results of previous studies and indicate that intensity modulated radiation therapy (IMRT) represents an effective and safe treatment approach for patients with sinonasal carcinomas.
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Soberón GS, Prado HM, Sadek A, Plowes O, Arrieta JR, Figueroa V. Proposal for staging of inflammatory lesions in the frontal region. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2015; 67:288-92. [PMID: 26589487 DOI: 10.1016/j.otorri.2015.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 06/29/2015] [Accepted: 07/21/2015] [Indexed: 11/25/2022]
Abstract
Frontal swelling can be due to multiple etiologies, including: mucocele, Pott's puffy tumor, fibro osseous lesions, benign and malignant neoplasms of the nose and paranasal sinuses, intracranial lesions, and metastasis. The objective of this study was to describe the clinical protocol used for the diagnosis of patients presented with frontal swelling and the proposal for staging of inflammatory lesions. We performed an observational retrospective analysis. We found 7 cases of patients with frontal swelling: 4 cases secondary to inflammatory pathology (3 Potts puffy tumors and one frontal mucocele), and 3 cases secondary to neoplasms (one benign and 2 malignant neoplasms). It's very important to consider the wide differential diagnosis that can present as frontal swelling, from inflammatory pathologies secondary to possible advanced infections of the paranasal sinuses to invasive malignant neoplasms. We propose a system of staging of frontal inflammatory lesions.
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Affiliation(s)
- Galo S Soberón
- Departamento de Otorrinolaringología y Cirugía de Cabeza y Cuello, Hospital General Dr. Manuel Gea González, Distrito Federal, México
| | - Héctor M Prado
- Departamento de Otorrinolaringología y Cirugía de Cabeza y Cuello, Hospital General Dr. Manuel Gea González, Distrito Federal, México.
| | - Andrés Sadek
- Departamento de Otorrinolaringología y Cirugía de Cabeza y Cuello, Hospital General Dr. Manuel Gea González, Distrito Federal, México
| | - Olga Plowes
- Departamento de Otorrinolaringología y Cirugía de Cabeza y Cuello, Hospital General Dr. Manuel Gea González, Distrito Federal, México
| | - José R Arrieta
- Departamento de Otorrinolaringología y Cirugía de Cabeza y Cuello, Hospital General Dr. Manuel Gea González, Distrito Federal, México
| | - Vladimir Figueroa
- División de Neurocirugía, Hospital General Dr. Manuel Gea González, Distrito Federal, México
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Lurquin E, Jorissen M, Debiec-Rychter M, Hermans R, Hauben E. Mammary analogue secretory carcinoma of the sinus ethmoidalis. Histopathology 2015; 67:749-51. [PMID: 25828788 DOI: 10.1111/his.12702] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Eveline Lurquin
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Mark Jorissen
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Leuven, Leuven, Belgium
| | - Maria Debiec-Rychter
- Center for Human Genetics, KU Leuven and University Hospital Leuven, Leuven, Belgium
| | - Robert Hermans
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Esther Hauben
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
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Hung CH, Chang KH, Chen YL, Wu YM, Lai CL, Chang HS, Lyu RK, Wu YR, Chen CM, Huang CC, Chu CC, Chen CH, Ro LS. Clinical and radiological findings suggesting disorders other than tolosa-hunt syndrome among ophthalmoplegic patients: a retrospective analysis. Headache 2015; 55:252-64. [PMID: 25688645 DOI: 10.1111/head.12488] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2014] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To investigate clinical and radiological features of Tolosa-Hunt syndrome (THS) and examine their diagnostic value, and to propose clinical and radiological features that indicate other symptomatic painful ophthalmoplegias (SPOs) in order to distinguish them from THS. BACKGROUND Clinical presentations of THS are nonspecific and may overlap with many etiologies. Therefore, excluding other SPOs is essential for correct diagnosis. At the present time, the predictive value of the current International Classification of Headache Disorders (ICHD) criteria is not well established, and specific imaging markers that can discriminate SPOs from THS are lacking. METHODS Patients referred with painful ophthalmoplegia over 12 years were recruited retrospectively and allocated into THS or SPO groups. Typical symptoms (episodic unilateral orbital pain preceding or developing with diplopia) and imaging of THS (inflammatory lesions in the cavernous sinus/orbit by magnetic resonance imaging) were proposed based on ICHD-3 beta criteria and previous literature. Atypical clinical and radiological features suggesting alternative diagnoses were also proposed to predict SPO. Initial presentations and imaging findings were registered and correlated with diagnostic outcomes. The predictive value of clinical and imaging findings was then evaluated. RESULTS Of the 61 referred cases, 25 were classified as THS and 36 as SPO. Of the SPO cases, 52.8% manifested typical THS symptoms at onset. Patients with SPOs were prone to have atypical symptoms (47.2%) and radiographical findings (82.1%) in comparison to those with THS (4.0% and 4.2%, respectively; both P < .001). Both typical symptoms and imaging findings predicted a diagnosis of THS with high sensitivity (95.8% and 100%, respectively) but low specificity (47.2% and 28.6%, respectively). High sensitivity (82.1%) and specificity (95.8%) were achieved using atypical imaging features to predict SPO. CONCLUSION A diagnosis of THS based strictly on clinical presentations or imaging results is not completely reliable. Identification of atypical imaging features may have a useful role in discriminating SPOs and thus avoid erroneous diagnoses of THS. Future studies with larger sample sizes are warranted to evaluate their validity in general population.
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Affiliation(s)
- Chih-Hsien Hung
- Department of Neurology, Kaohsiung Municipal Hsiaokang Hospital, Kaohsiung, Taiwan; Department of Neurology, Kaohsiung Medical University Hospital; Kaohsiung Medical University, Kaohsiung, Taiwan; Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
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Gray ST, Sadow PM, Lin DT, Sedaghat AR. Endoscopic sinus surgery for chronic rhinosinusitis in patients previously treated for sinonasal malignancy. Laryngoscope 2015; 126:304-15. [PMID: 26309057 DOI: 10.1002/lary.25435] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVES/HYPOTHESIS Patients with a history of sinonasal malignancy can develop chronic rhinosinusitis (CRS) as a consequence of their oncologic treatment. Some patients will fail medical management and require endoscopic sinus surgery (ESS). This study reviews the use of ESS in the management of CRS in patients previously treated for sinonasal malignancy. STUDY DESIGN Retrospective review. METHODS All patients with a history of sinonasal malignancy who developed CRS and underwent ESS were reviewed. Preoperative and postoperative imaging and symptoms were collected. Major complications (bleeding, orbital injury, and cerebrospinal fluid leak) and minor complications (adhesion formation) and postoperative healing were reviewed. RESULTS Eighteen patients were identified. All patients presented with symptoms of CRS and sinonasal crusting. Additionally, five patients presented with recurrent facial cellulitis, and six patients had mucoceles. No major complications were encountered. Postoperatively, all patients reported a subjective improvement in their sinonasal symptoms. Comparison of pre- and post-ESS imaging revealed a significant improvement in Lund-Mackay scores after ESS (P < 0.001) from 12.8 (range 5-22) to 7 (range). Despite symptomatic improvement, all patients continued to have nasal crusting. All patients who initially presented with recurrent facial cellulitis had no further episodes after ESS. None of the endoscopically drained mucoceles recurred. CONCLUSION For patients previously treated for sinonasal malignancy with refractory CRS, ESS appears to be a safe and effective treatment option. ESS in these patients results in subjective improvement in sinonasal symptoms as well as objective improvement in radiographic CRS disease burden, although sinonasal crusting will likely not resolve. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Stacey T Gray
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary.,Department of Otology and Laryngology
| | - Peter M Sadow
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Derrick T Lin
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary.,Department of Otology and Laryngology
| | - Ahmad R Sedaghat
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary.,Department of Otology and Laryngology
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Smith SP, Russell JL, Chen NW, Kuo YF, Resto VA. Sinonasal Carcinoma: Racial and Ethnic Disparities in Survival--A Review of 4714 Patients. Otolaryngol Head Neck Surg 2015; 153:551-60. [PMID: 26163451 DOI: 10.1177/0194599815593277] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 06/05/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine whether or not patient race and ethnicity affect sinonasal cancer survival. STUDY DESIGN Retrospective database analysis. SETTING National Cancer Institute's Surveillance, Epidemiology, and End Results Database, 1988-2010. SUBJECTS AND METHODS Sinonasal carcinoma cases were extracted according to site codes and histology recode-broad groupings. The cohort was used to calculate disease-specific survival in regard to race and ethnicity. Extracted data were further analyzed through direct comparisons and multivariable Cox regression models controlling for patient, tumor, and treatment characteristics. RESULTS Unadjusted survival curves for all sinonasal carcinomas showed poorer disease-specific survival for black versus white patients (P = .02), which was eliminated after controlling for tumor characteristics (hazard ratio: 1.02, P = .86). Specifically for sinonasal squamous cell carcinoma, significantly poorer disease-specific survival was found for both black (P = .01) and Hispanic (P = .01) patients as compared with white patients. Similarly, when controlling for tumor characteristics, the disease-specific survival disparity was eliminated for black (hazard ratio: 0.93, P = .59) and Hispanic patients (hazard ratio: 1.01, P = .94). CONCLUSION Black race is a risk factor for poorer disease-specific survival when all sinonasal histologic subtypes are examined together. Specifically for sinonasal squamous cell carcinoma, both black race and Hispanic ethnicity are risk factors for poorer disease-specific survival. When tumor characteristics are controlled for in this cohort, the survival disparity is eliminated, demonstrating that the disparity can be accounted for exclusively by more advanced disease at presentation, opposed to the more complex effect seen in other subsites of the head and neck.
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Affiliation(s)
- Steven P Smith
- Department of Otolaryngology-Head and Neck Surgery, UTMB Health, Galveston, Texas, USA
| | - Joseph L Russell
- Department of Otolaryngology-Head and Neck Surgery, UTMB Health, Galveston, Texas, USA
| | - Nai-Wei Chen
- Biostatistics Core, Department of Preventive Medicine and Community Health, UTMB Health, Galveston, Texas, USA
| | - Yong-Fang Kuo
- Biostatistics Core, Department of Preventive Medicine and Community Health, UTMB Health, Galveston, Texas, USA
| | - Vicente A Resto
- Department of Otolaryngology-Head and Neck Surgery, UTMB Health, Galveston, Texas, USA
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Chen MM, Roman SA, Sosa JA, Judson BL. Predictors of Survival in Sinonasal Adenocarcinoma. J Neurol Surg B Skull Base 2015. [PMID: 26225303 DOI: 10.1055/s-0034-1543995] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Objectives To identify factors associated with disease-specific survival (DSS) in intestinal and nonintestinal sinonasal adenocarcinoma. Design Retrospective review. Setting Surveillance Epidemiology and End Results database. Participants Adult patients with sinonasal adenocarcinoma. Main Outcome Measures DSS. Results We identified 325 patients; of these, 300 had the nonintestinal type and 25 had intestinal type histologies. The 5-year DSS rates for patients who had no treatment, radiation (RT), surgery, and surgery and postoperative RT were 42.5, 46.1, 85.6, and 72.6%, respectively (log-rank test; p < 0.001). Black race, age ≥ 75 years, paranasal sinus involvement, and high grade were independently associated with decreased DSS. Compared with RT, surgery (hazard ratio [HR]: 0.34; 95% confidence interval [CI]: 0.15-0.77), and adjuvant RT (HR: 0.47; 95% CI, 0.26-0.86) were associated with improved DSS. Conclusions There is no difference in prognosis between intestinal and nonintestinal subtypes of sinonasal adenocarcinoma. Treatment with surgery alone or adjuvant RT is associated with a more favorable prognosis.
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Affiliation(s)
- Michelle M Chen
- Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, United States
| | - Sanziana A Roman
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina, United States
| | - Julie A Sosa
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina, United States ; Endocrine Neoplasia Diseases Group, Duke Clinical Research Institute, Duke University, Durham, North Carolina, United States
| | - Benjamin L Judson
- Section of Otolaryngology, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, United States
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Reyes C, Mason E, Solares CA, Bush C, Carrau R. To preserve or not to preserve the orbit in paranasal sinus neoplasms: a meta-analysis. J Neurol Surg B Skull Base 2014; 76:122-8. [PMID: 25844298 DOI: 10.1055/s-0034-1390403] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 07/21/2014] [Indexed: 10/24/2022] Open
Abstract
Context The effect on survival of orbital evisceration on patients with paranasal sinus neoplasms has not been well established. Objective To review systematically the available literature concerning survival in patients who undergo surgery for paranasal sinus neoplasm with and without preservation of the eye. Data Source A retrospective meta-analysis of English and non-English articles using Medline and the Cochrane database. Eligibility Criteria Studies analyzing 5-year survival rates in patients who had orbital evisceration compared with orbital preservation for the treatment of paranasal sinus neoplasms were included in the final analysis. Data Extraction Independent review by two authors using predefined data fields. Data Synthesis A meta-analysis of four articles involving 443 patients was performed using the DerSimonian-Laird random-effects method. Results Our analysis revealed a total effect size of 0.964 in favor of preservation of the eye; however, these results are not robust, having a true effect size anywhere from 0.785 to 1.142 with a 95% confidence interval. Limitations Only retrospective observational studies were included because a prospective randomized study cannot be performed in this population. Conclusion Our study supports the notion that in select patients preservation of the eye may yield a different outcome when compared with orbital evisceration.
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Affiliation(s)
- Camilo Reyes
- Department of Otolaryngology, Universidad del Rosario, Bogota, Colombia
| | - Eric Mason
- Department of Otolaryngology, Georgia Regents University, Augusta, Georgia, United States ; Center for Skull Base Surgery, Georgia Regents University, Augusta, Georgia, United States
| | - C Arturo Solares
- Department of Otolaryngology, Georgia Regents University, Augusta, Georgia, United States ; Center for Skull Base Surgery, Georgia Regents University, Augusta, Georgia, United States
| | - Carrie Bush
- Department of Otolaryngology, Georgia Regents University, Augusta, Georgia, United States
| | - Ricardo Carrau
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
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Agaimy A, Koch M, Lell M, Semrau S, Dudek W, Wachter DL, Knöll A, Iro H, Haller F, Hartmann A. SMARCB1(INI1)-deficient sinonasal basaloid carcinoma: a novel member of the expanding family of SMARCB1-deficient neoplasms. Am J Surg Pathol 2014; 38:1274-81. [PMID: 24832165 PMCID: PMC4141899 DOI: 10.1097/pas.0000000000000236] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Poorly differentiated sinonasal carcinomas are a heterogenous group of aggressive neoplasms that encompasses squamous cell carcinoma including basaloid variant, lymphoepithelial carcinoma, sinonasal undifferentiated carcinoma, and neuroendocrine-type small cell carcinoma. We herein describe 3 cases of a hitherto unreported variant combining features of basaloid carcinoma with variable intermingled rhabdoid cells. Patients were 2 women (aged 28 and 35) and a man (52 y) who presented with sinonasal masses. All had advanced local disease with bone involvement (pT4). None had a history of irradiation or a family history of rhabdoid tumors. Treatment was surgery and adjuvant chemoradiation. One patient developed liver, lung, pleural, and pericardial metastases (63 mo) and is currently (70 mo) alive under palliative treatment. Another developed recurrent cervical lymph node metastases and died of disease 8.5 years later. The youngest patient was disease-free at last follow-up 7 years later. Histologic features were very similar in all 3 cases and showed intimate admixture of compact basaloid cell nests with peripheral palisading, perivascular pseudorosettes, and a few scattered rhabdoid cells. Rhabdoid cells were more extensive in the metastasis in 1 case but formed a minor inconspicuous component in the primary tumors in all cases. Striking features common to all cases were (1) basaloid “blue” appearance at low power, (2) papilloma-like exophytic component, (3) extensive pagetoid surface growth with prominent denuding features, and (4) replacement of underlying mucous glands mimicking an inverted papilloma. Clear-cut origin from benign papilloma and overt squamous differentiation were lacking. Diffuse (2) or partial (1) p16 expression was noted, but all cases lacked human papillomavirus DNA by molecular tests. In situ hybridization was negative for Epstein-Barr virus. Immunohistochemistry showed diffuse expression of pancytokeratin. CK5 and vimentin showed intermingling of CK5+/vimentin− basaloid and CK5−/vimentin+ rhabdoid cells. Complete loss of nuclear SMARCB1 expression was seen in all cases including also the denuding carcinoma in situ–like surface lesions. To our knowledge, this variant of sinonasal carcinoma has not been reported before. The identical features in all 3 cases suggest a specific disease rather than a nonspecific dedifferentiated phenotype. Awareness of this rare variant and thus reporting of additional cases is necessary for defining its full morphologic and biological spectrum.
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Affiliation(s)
- Abbas Agaimy
- *Institute of Pathology †Department of Otorhinolaryngology Head and Neck Surgery ‡Institute of Diagnostic and Interventional Radiology Departments of §Radiation Therapy ∥Thoracic Surgery ¶Institute of Virology, University Hospital of Erlangen, Erlangen, Germany
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Wang X, Zhang Z, Chen Q, Li J, Xian J. Effectiveness of 3 T PROPELLER DUO diffusion-weighted MRI in differentiating sinonasal lymphomas and carcinomas. Clin Radiol 2014; 69:1149-56. [PMID: 25115306 DOI: 10.1016/j.crad.2014.07.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 06/22/2014] [Accepted: 07/01/2014] [Indexed: 10/24/2022]
Abstract
AIM To evaluate the value of 3 T Periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) DUO diffusion-weighted MRI (DW-MRI) in differentiating sinonasal lymphomas from carcinomas. MATERIALS AND METHODS PROPELLER DUO DW-MRI was performed in 23 patients with sinonasal lymphomas and 28 patients with carcinomas histologically confirmed at 3 T MRI. Apparent diffusion coefficients (ADCs) were obtained with two different b-values (b = 0 and 700 s/mm(2), b = 0 and 1000 s/mm(2)) and two different regions of interest (ROIs) sampling strategies [whole section (WS), partial section (PS)], respectively. Difference in ADCs between sinonasal lymphomas and carcinomas was evaluated using the independent samples t-test or Mann-Whitney U-test. The utility of ADC thresholds for discriminating between them was evaluated by receiver operating characteristic analysis. RESULTS ADCs of sinonasal lymphomas (WS ADCb0,700, 0.838 × 10(-3) mm(2)/s) were significantly (p < 0.001) lower than those of carcinomas (WS ADCb0,700, 1.396 × 10(-3) mm(2)/s). Using a WS ADC b0,700 value of 1.040 × 10(-3) mm(2)/s as the threshold value effectively differentiated sinonasal lymphomas from carcinomas with 100% sensitivity, 82.1% specificity, and 82.1% positive and 100% negative predictive values and 90.2% accuracy (b = 0, 700 s/mm(2)). There was no significant difference in diagnostic ability between different b-values settings (p > 0.05) and different sampling strategies of ROIs (p > 0.05), respectively. Additionally, there was significant differences in the ADCs between diffuse large B-cell lymphomas and natural killer (NK)/T-cell lymphomas (p < 0.05). CONCLUSION PROPELLER DUO DW-MRI can effectively differentiate sinonasal lymphomas from carcinomas.
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Affiliation(s)
- X Wang
- From the Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Z Zhang
- From the Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Q Chen
- From the Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - J Li
- From the Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - J Xian
- From the Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Nasal Diseases, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
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Abstract
The sinonasal cavities represent an anatomical region affected by a variety of tumours with clinical, aetiological, pathological, and genetic features distinct from tumours at the main head and neck cancer localizations. Together, squamous-cell carcinoma and adenocarcinoma account for 80% of all sinonasal tumours, and are aetiologically associated with professional exposure to wood and leather dust particles and other industrial compounds, and therefore, are officially recognized as an occupational disease. Owing to their distinctive characteristics, sinonasal tumours should be considered as separate entities, not to be included in the miscellany of head and neck cancers. Sinonasal tumours are rare, with an annual incidence of approximately 1 case per 100,000 inhabitants worldwide, a fact that has hampered molecular-genetic studies of the tumorigenic pathways and the testing of alternative treatment strategies. Nevertheless, the clinical management of sinonasal cancer has improved owing to advances in imaging techniques, endoscopic surgical approaches, and radiotherapy. Genetic profiling and the development of in vitro cell lines and animal models currently form the basis for future targeted anticancer therapies. We review these advances in our understanding and treatment of sinonasal tumours.
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Biron VL, Lentsch EJ, Gerry DR, Bewley AF. Case-control analysis of survival outcomes in sinonasal acinic cell carcinoma. Int Forum Allergy Rhinol 2014; 4:507-11. [PMID: 24599557 DOI: 10.1002/alr.21301] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 12/13/2013] [Accepted: 12/30/2013] [Indexed: 11/07/2022]
Abstract
BACKGROUND Acinic cell carcinoma (AciCC) is an uncommon malignant-epithelial salivary gland cancer. In very rare cases, this tumor may arise from sinonasal subsites, with only 19 cases described in the English-language literature. METHODS We performed a retrospective analysis of 18 cases of AciCC, obtained from searching the Surveillance, Epidemiology, and End Results (SEER) database between 1973 and 2009. RESULTS Patient demographics, including age, gender, and race, were similar to AciCC cases found in more common locations. However, all patients had low-grade tumors without regional or distant metastases. Comparing these patients to a stage, grade, and treatment-matched cohort of parotid AciCC, we found a lower 10-year overall survival (52.3%) with no significant difference in disease-specific survival (88.9%). Our meta-analysis of survival from cases in the literature estimated 10-year recurrence-free survival at 92.9%. CONCLUSION To our knowledge, this is the largest cohort of patients with AciCC reported in the English-language literature. Our results suggest that patients with sinonasal AciCC have excellent disease-specific survival, comparable to matched patients with AciCC in more common salivary gland subsites.
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Affiliation(s)
- Vincent L Biron
- Department of Otolaryngology, University of California Davis, Sacramento, CA
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