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Karamitsou P, Poutoglidis A, Skliris JP, Matzarakis I, Gougousis S. An Extremely Rare Nasopharyngeal Malignant Tumor: A Case Report. Cureus 2022; 14:e31444. [DOI: 10.7759/cureus.31444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2022] [Indexed: 11/15/2022] Open
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Patel NN, Maina IW, Kuan EC, Triantafillou V, Trope MA, Carey RM, Workman AD, Tong CC, Kohanski MA, Palmer JN, Adappa ND, Newman JG, Brant JA. Adenocarcinoma of the Sinonasal Tract: A Review of the National Cancer Database. J Neurol Surg B Skull Base 2019; 81:701-708. [PMID: 33381376 DOI: 10.1055/s-0039-1696707] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 07/28/2019] [Indexed: 12/13/2022] Open
Abstract
Background Sinonasal adenocarcinoma (SNAC) is a rare malignancy arising from mucus-secreting glandular tissue. Limited large-scale studies are available due to its rarity. We evaluated SNAC in the National Cancer Database (NCDB), a source that affords multi-institutional, population studies of rare cancers and their outcomes. Methods The NCDB was queried for adenocarcinoma in the sinonasal tract. Multivariate analyses were performed to evaluate for factors contributing to overall survival (OS). Results A total of 553 patients were identified. The cohort was composed of 59.3% males. The nasal cavity was the most common primary site, representing 44.1% of cases. About 5.7% of patients presented with nodal disease, while 3.3% had distant metastases. About 40.6% of cases presented with stage IV disease. About 73.5% of patients underwent surgery, 54.2% received radiation therapy, and 27.7% had chemotherapy. Median OS was 71.7 months, while OS at 1, 2, and 5 years was 82, 73.0, and 52%, respectively. On multivariate analysis, advanced age (hazard ratio [HR]: 1.04; 95% confidence interval [CI]: 1.02-1.05), Charlson-Deyo score of 1 (HR: 1.99; 95% CI: 1.20-3.30), advanced tumor grade (HR: 2.73; 95% CI: 1.39-5.34), and advanced tumor stage (HR: 2.71; 95% CI: 1.33-5.50) were associated with worse OS, whereas surgery (HR: 0.34; 95% CI: 0.20-0.60) and radiation therapy (HR: 0.55; 95% CI: 0.33-0.91), but not chemotherapy (HR: 1.16; 95% CI: 0.66-2.05), predicted improved OS. Conclusions SNAC is a rare malignancy with 5-year survival approximating 50%. Surgery and radiation therapy, but not chemotherapy, are associated with improved survival, and likely play a critical role in the interdisciplinary management of SNAC.
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Affiliation(s)
- Neil N Patel
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Ivy W Maina
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Edward C Kuan
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Vasiliki Triantafillou
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Michal A Trope
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Ryan M Carey
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Alan D Workman
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Charles C Tong
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Michael A Kohanski
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - James N Palmer
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Nithin D Adappa
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Jason G Newman
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Jason A Brant
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
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Franchi A, Bishop JA, Coleman H, Flucke U, Licitra LF, Pendás JLL, Stelow EB, Toner M, Weinreb I, Wenig BM, Thompson LDR. Data Set for the Reporting of Carcinomas of the Nasal Cavity and Paranasal Sinuses: Explanations and Recommendations of the Guidelines From the International Collaboration on Cancer Reporting. Arch Pathol Lab Med 2018; 143:424-431. [PMID: 30500298 DOI: 10.5858/arpa.2018-0404-sa] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The International Collaboration on Cancer Reporting was established to internationally unify and standardize the pathologic reporting of cancers based on collected evidence, as well as to allow systematic multi-institutional intercountry data collection to guide cancer care in the future. This data set has been developed by the collaborative efforts of an international multidisciplinary panel of experts involved in the care of patients with carcinomas of the nasal cavity and paranasal sinuses (sinonasal tract). The nasal cavity and paranasal sinuses (including frontal, sphenoid, ethmoid, and maxillary sinuses) comprise a very complex anatomic area of the head and neck, affected by a sometimes bewildering array of neoplasms. Management of malignancies in this anatomic region involves complex surgery because of the anatomic confines and close proximity to many vital structures. Given a multidisciplinary approach, the standardized reporting of the carcinomas that develop in this anatomic region include both required (core) and recommended (noncore) elements in pathology reporting in order to be able to identify critical prognostic factors, often requiring clinical and radiologic correlation. A summary of the International Collaboration on Cancer Reporting guidelines and clinically relevant elements, along with additional explanatory notes, are provided, based on evidentiary support from the literature, set in the context of practical application.
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Affiliation(s)
- Alessandro Franchi
- From the Department of Translational Research, University of Pisa, Pisa, Italy (Dr Franchi); the Department of Pathology, University of Texas Southwestern Medical Center, Dallas (Dr Bishop); the Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, Australia (Dr Coleman); the Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands (Dr Flucke); the Head and Neck Medical Oncology Department, Fondazione International Collaboration on Cancer Reporting Istituto Nazionale dei Tumori, and University of Milan, Milan, Italy (Dr Licitra); the Department of Otolaryngology, Instituto Universitario de Oncología del Principado de Asturias, Centro de Investigación Biomédica en Red de Cancer, Hospital Universitario Central de Asturias, Oviedo, Spain (Dr Llorente Pendás); the Department of Pathology, University of Virginia, Charlottesville (Dr Stelow); St James and Dublin Dental Hospitals and Trinity College, Sir Patrick Dunne Research Laboratory, and St James Hospital, Dublin, Ireland (Dr Toner); the Department of Pathology, University Health Network, Toronto, Ontario, Canada (Dr Weinreb); the Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida (Dr Wenig); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - Justin A Bishop
- From the Department of Translational Research, University of Pisa, Pisa, Italy (Dr Franchi); the Department of Pathology, University of Texas Southwestern Medical Center, Dallas (Dr Bishop); the Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, Australia (Dr Coleman); the Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands (Dr Flucke); the Head and Neck Medical Oncology Department, Fondazione International Collaboration on Cancer Reporting Istituto Nazionale dei Tumori, and University of Milan, Milan, Italy (Dr Licitra); the Department of Otolaryngology, Instituto Universitario de Oncología del Principado de Asturias, Centro de Investigación Biomédica en Red de Cancer, Hospital Universitario Central de Asturias, Oviedo, Spain (Dr Llorente Pendás); the Department of Pathology, University of Virginia, Charlottesville (Dr Stelow); St James and Dublin Dental Hospitals and Trinity College, Sir Patrick Dunne Research Laboratory, and St James Hospital, Dublin, Ireland (Dr Toner); the Department of Pathology, University Health Network, Toronto, Ontario, Canada (Dr Weinreb); the Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida (Dr Wenig); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - Hedley Coleman
- From the Department of Translational Research, University of Pisa, Pisa, Italy (Dr Franchi); the Department of Pathology, University of Texas Southwestern Medical Center, Dallas (Dr Bishop); the Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, Australia (Dr Coleman); the Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands (Dr Flucke); the Head and Neck Medical Oncology Department, Fondazione International Collaboration on Cancer Reporting Istituto Nazionale dei Tumori, and University of Milan, Milan, Italy (Dr Licitra); the Department of Otolaryngology, Instituto Universitario de Oncología del Principado de Asturias, Centro de Investigación Biomédica en Red de Cancer, Hospital Universitario Central de Asturias, Oviedo, Spain (Dr Llorente Pendás); the Department of Pathology, University of Virginia, Charlottesville (Dr Stelow); St James and Dublin Dental Hospitals and Trinity College, Sir Patrick Dunne Research Laboratory, and St James Hospital, Dublin, Ireland (Dr Toner); the Department of Pathology, University Health Network, Toronto, Ontario, Canada (Dr Weinreb); the Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida (Dr Wenig); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - Uta Flucke
- From the Department of Translational Research, University of Pisa, Pisa, Italy (Dr Franchi); the Department of Pathology, University of Texas Southwestern Medical Center, Dallas (Dr Bishop); the Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, Australia (Dr Coleman); the Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands (Dr Flucke); the Head and Neck Medical Oncology Department, Fondazione International Collaboration on Cancer Reporting Istituto Nazionale dei Tumori, and University of Milan, Milan, Italy (Dr Licitra); the Department of Otolaryngology, Instituto Universitario de Oncología del Principado de Asturias, Centro de Investigación Biomédica en Red de Cancer, Hospital Universitario Central de Asturias, Oviedo, Spain (Dr Llorente Pendás); the Department of Pathology, University of Virginia, Charlottesville (Dr Stelow); St James and Dublin Dental Hospitals and Trinity College, Sir Patrick Dunne Research Laboratory, and St James Hospital, Dublin, Ireland (Dr Toner); the Department of Pathology, University Health Network, Toronto, Ontario, Canada (Dr Weinreb); the Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida (Dr Wenig); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - Lisa F Licitra
- From the Department of Translational Research, University of Pisa, Pisa, Italy (Dr Franchi); the Department of Pathology, University of Texas Southwestern Medical Center, Dallas (Dr Bishop); the Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, Australia (Dr Coleman); the Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands (Dr Flucke); the Head and Neck Medical Oncology Department, Fondazione International Collaboration on Cancer Reporting Istituto Nazionale dei Tumori, and University of Milan, Milan, Italy (Dr Licitra); the Department of Otolaryngology, Instituto Universitario de Oncología del Principado de Asturias, Centro de Investigación Biomédica en Red de Cancer, Hospital Universitario Central de Asturias, Oviedo, Spain (Dr Llorente Pendás); the Department of Pathology, University of Virginia, Charlottesville (Dr Stelow); St James and Dublin Dental Hospitals and Trinity College, Sir Patrick Dunne Research Laboratory, and St James Hospital, Dublin, Ireland (Dr Toner); the Department of Pathology, University Health Network, Toronto, Ontario, Canada (Dr Weinreb); the Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida (Dr Wenig); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - José Luis Llorente Pendás
- From the Department of Translational Research, University of Pisa, Pisa, Italy (Dr Franchi); the Department of Pathology, University of Texas Southwestern Medical Center, Dallas (Dr Bishop); the Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, Australia (Dr Coleman); the Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands (Dr Flucke); the Head and Neck Medical Oncology Department, Fondazione International Collaboration on Cancer Reporting Istituto Nazionale dei Tumori, and University of Milan, Milan, Italy (Dr Licitra); the Department of Otolaryngology, Instituto Universitario de Oncología del Principado de Asturias, Centro de Investigación Biomédica en Red de Cancer, Hospital Universitario Central de Asturias, Oviedo, Spain (Dr Llorente Pendás); the Department of Pathology, University of Virginia, Charlottesville (Dr Stelow); St James and Dublin Dental Hospitals and Trinity College, Sir Patrick Dunne Research Laboratory, and St James Hospital, Dublin, Ireland (Dr Toner); the Department of Pathology, University Health Network, Toronto, Ontario, Canada (Dr Weinreb); the Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida (Dr Wenig); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - Edward B Stelow
- From the Department of Translational Research, University of Pisa, Pisa, Italy (Dr Franchi); the Department of Pathology, University of Texas Southwestern Medical Center, Dallas (Dr Bishop); the Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, Australia (Dr Coleman); the Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands (Dr Flucke); the Head and Neck Medical Oncology Department, Fondazione International Collaboration on Cancer Reporting Istituto Nazionale dei Tumori, and University of Milan, Milan, Italy (Dr Licitra); the Department of Otolaryngology, Instituto Universitario de Oncología del Principado de Asturias, Centro de Investigación Biomédica en Red de Cancer, Hospital Universitario Central de Asturias, Oviedo, Spain (Dr Llorente Pendás); the Department of Pathology, University of Virginia, Charlottesville (Dr Stelow); St James and Dublin Dental Hospitals and Trinity College, Sir Patrick Dunne Research Laboratory, and St James Hospital, Dublin, Ireland (Dr Toner); the Department of Pathology, University Health Network, Toronto, Ontario, Canada (Dr Weinreb); the Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida (Dr Wenig); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - Mary Toner
- From the Department of Translational Research, University of Pisa, Pisa, Italy (Dr Franchi); the Department of Pathology, University of Texas Southwestern Medical Center, Dallas (Dr Bishop); the Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, Australia (Dr Coleman); the Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands (Dr Flucke); the Head and Neck Medical Oncology Department, Fondazione International Collaboration on Cancer Reporting Istituto Nazionale dei Tumori, and University of Milan, Milan, Italy (Dr Licitra); the Department of Otolaryngology, Instituto Universitario de Oncología del Principado de Asturias, Centro de Investigación Biomédica en Red de Cancer, Hospital Universitario Central de Asturias, Oviedo, Spain (Dr Llorente Pendás); the Department of Pathology, University of Virginia, Charlottesville (Dr Stelow); St James and Dublin Dental Hospitals and Trinity College, Sir Patrick Dunne Research Laboratory, and St James Hospital, Dublin, Ireland (Dr Toner); the Department of Pathology, University Health Network, Toronto, Ontario, Canada (Dr Weinreb); the Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida (Dr Wenig); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - Ilan Weinreb
- From the Department of Translational Research, University of Pisa, Pisa, Italy (Dr Franchi); the Department of Pathology, University of Texas Southwestern Medical Center, Dallas (Dr Bishop); the Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, Australia (Dr Coleman); the Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands (Dr Flucke); the Head and Neck Medical Oncology Department, Fondazione International Collaboration on Cancer Reporting Istituto Nazionale dei Tumori, and University of Milan, Milan, Italy (Dr Licitra); the Department of Otolaryngology, Instituto Universitario de Oncología del Principado de Asturias, Centro de Investigación Biomédica en Red de Cancer, Hospital Universitario Central de Asturias, Oviedo, Spain (Dr Llorente Pendás); the Department of Pathology, University of Virginia, Charlottesville (Dr Stelow); St James and Dublin Dental Hospitals and Trinity College, Sir Patrick Dunne Research Laboratory, and St James Hospital, Dublin, Ireland (Dr Toner); the Department of Pathology, University Health Network, Toronto, Ontario, Canada (Dr Weinreb); the Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida (Dr Wenig); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - Bruce M Wenig
- From the Department of Translational Research, University of Pisa, Pisa, Italy (Dr Franchi); the Department of Pathology, University of Texas Southwestern Medical Center, Dallas (Dr Bishop); the Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, Australia (Dr Coleman); the Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands (Dr Flucke); the Head and Neck Medical Oncology Department, Fondazione International Collaboration on Cancer Reporting Istituto Nazionale dei Tumori, and University of Milan, Milan, Italy (Dr Licitra); the Department of Otolaryngology, Instituto Universitario de Oncología del Principado de Asturias, Centro de Investigación Biomédica en Red de Cancer, Hospital Universitario Central de Asturias, Oviedo, Spain (Dr Llorente Pendás); the Department of Pathology, University of Virginia, Charlottesville (Dr Stelow); St James and Dublin Dental Hospitals and Trinity College, Sir Patrick Dunne Research Laboratory, and St James Hospital, Dublin, Ireland (Dr Toner); the Department of Pathology, University Health Network, Toronto, Ontario, Canada (Dr Weinreb); the Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida (Dr Wenig); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
| | - Lester D R Thompson
- From the Department of Translational Research, University of Pisa, Pisa, Italy (Dr Franchi); the Department of Pathology, University of Texas Southwestern Medical Center, Dallas (Dr Bishop); the Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, Australia (Dr Coleman); the Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands (Dr Flucke); the Head and Neck Medical Oncology Department, Fondazione International Collaboration on Cancer Reporting Istituto Nazionale dei Tumori, and University of Milan, Milan, Italy (Dr Licitra); the Department of Otolaryngology, Instituto Universitario de Oncología del Principado de Asturias, Centro de Investigación Biomédica en Red de Cancer, Hospital Universitario Central de Asturias, Oviedo, Spain (Dr Llorente Pendás); the Department of Pathology, University of Virginia, Charlottesville (Dr Stelow); St James and Dublin Dental Hospitals and Trinity College, Sir Patrick Dunne Research Laboratory, and St James Hospital, Dublin, Ireland (Dr Toner); the Department of Pathology, University Health Network, Toronto, Ontario, Canada (Dr Weinreb); the Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida (Dr Wenig); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
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Urso C, Ninu MB, Franchi A, Paglierani M, Bondi R. Intestinal-Type Adenocarcinoma of the Sinonasal Tract: A Clinicopathologic Study of 18 Cases. TUMORI JOURNAL 2018; 79:205-10. [PMID: 8236506 DOI: 10.1177/030089169307900310] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Intestinal-type adenocarcinoma (ITAC) of the nose and paranasal sinuses is a relatively rare tumor. It commonly affects subjects exposed to wood or leather dust. Methods The authors present the clinicopathologic findings of 18 cases of sinonasal ITACs and review the proposed histologic classifications. Results All patients, except one, were males; mean age was 60 years (range, 41-79); in 9 cases an occupational exposure to wood or leather dust was found. Common presenting symptoms were epistaxis, nasal obstruction and rhinorrhea. Histologically, tumors were divided into four groups: well-differentiated (G1) ITACs = 3 cases; moderately differentiated (G2) ITACs = 8 cases; poorly differentiated (G3) ITACs = 2 cases; mucinous (M) ITACs = 5 cases. Immunocytochemically, 16/17 cases were positive for carcinoembryonal antigen, 1/17 for somatostatin, and 0/16 cases for gastrin. Conclusions Sinonasal ITACs are aggressive tumors, often diagnosed in a relatively advanced stage. Owing the close similarity of the microscopic aspects, a histologic classification of ITACs analogous to that of colonic adenocarcinomas is proposed.
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Affiliation(s)
- C Urso
- Istitut di Anatomia e Istologia Patologica, Università di Firenze, Italy
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5
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López JI, Nevado M, Eizaguirre B, Pérez A. Intestinal-Type Adenocarcinoma of the Nasal Cavity and Paranasal Sinuses. A Clinicopathologic Study of 6 Cases. TUMORI JOURNAL 2018; 76:250-4. [PMID: 2368169 DOI: 10.1177/030089169007600308] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The clinical and pathologic features of 6 cases of intestinal-type adenocarcinoma of the sinonasal region are presented. These cases were collected in a 17 year period (1972-1988) and account for less than 4% of malignancies of this region in our records for this period. All of the patients were men aged 48 to 82 years (mean, 54 years). Previous exposure to wood dust was reported in 1 case. Radiographic studies, especially computerized tomography, were of critical importance to delineate the extent of tumors. Nasal obstruction was the most common compliant. Duration of symptoms prior to diagnosis is available in 5 cases and ranged from 5 to 36 months (mean 18 months). Surgical treatment was performed in 4 patients (of palliative type in 2) followed by radiotherapy in 3. Histo-pathology revealed tubulo-papillary (5 cases) and mucinous (1 case) patterns. Follow-up is available in all patients (range 0 to 108 months), 50% of whom are still alive. In our series, only 1 patient has survived more than 5 years. Data pooled from the literature reveal that 53% of patients have experienced local recurrences following therapy, and 60% have died of their disease. Of these deaths, 80% occurred within 5 years of diagnosis.
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Affiliation(s)
- J I López
- Service of Pathology, Hospital Civil de Bilbao, Spain
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7
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Diagnosis of Primary Intestinal-Type Adenocarcinoma in the Nasal Cavity by 18F-FDG PET/CT. Clin Nucl Med 2016; 41:888-889. [PMID: 27607163 DOI: 10.1097/rlu.0000000000001363] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
A soft-tissue lesion in the left nasal cavity was found on a 70-year-old man, which was pathologically proved to be an intestinal-type adenocarcinoma (ITAC) by biopsy. F-FDG PET/CT scan was performed to exclude the possibilities of metastasis from the other primary adenocarcinomas, but the nasal tumor was found to be the only lesion with F-FDG avidity. The primary ITAC in the nasal cavity was diagnosed, and it was resected successfully.
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Abstract
The nasal cavity and paranasal sinuses occupy the top of the upper respiratory tract and form pneumatic spaces connected with the atmosphere. They are located immediately beneath the base of the cranium, where crucial vital structures are harbored. From this region, very much exposed to airborne agents, arise some of the more complex and rare benign and malignant lesions seen in humans, whose difficulties in interpretation make this remarkable territory one of the most challenging in the practice of surgical pathology. Contents of this chapter cover inflammations and infections, polyps and pseudotumors, fungal and midfacial destructive granulomatous lesions, as well as benign, borderline, and malignant neoplasms. Among the neoplasms, emphasis is made on those entities characteristic or even unique for the sinonasal region, such as Schneiderian papillomas, glomangiopericytoma, intestinal- and non-intestinal-type adenocarcinomas, olfactory neuroblastoma, nasal-type NK-/T-cell lymphoma, and teratocarcinosarcoma. Moreover, recently recognized entities involving this territory, i.e., HPV-related non-keratinizing carcinoma, NUT carcinoma, and SMARCB1-deficient basaloid carcinoma, are also discussed in the light of their specific molecular findings. Furthermore, the text is accompanied by numerous classical and recent references, several tables, and 100 illustrations.
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Affiliation(s)
- Antonio Cardesa
- University of Barcelona, Anatomic Pathology Hospital Clínic University of Barcelona, Barcelona, Spain
| | - Pieter J. Slootweg
- Radboud Univ Nijmegen Medical Center, Pathology Radboud Univ Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Nina Gale
- University of Ljubljana,, Institute of Pathology, Faculty of Medic University of Ljubljana,, Ljublijana, Slovenia
| | - Alessandro Franchi
- University of Florence, Dept of Surg & Translational Medicine University of Florence, Florence, Italy
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Meccariello G, Deganello A, Choussy O, Gallo O, Vitali D, De Raucourt D, Georgalas C. Endoscopic nasal versus open approach for the management of sinonasal adenocarcinoma: A pooled-analysis of 1826 patients. Head Neck 2015; 38 Suppl 1:E2267-74. [DOI: 10.1002/hed.24182] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2015] [Indexed: 11/05/2022] Open
Affiliation(s)
- Giuseppe Meccariello
- Academic Clinic of Otolaryngology and Head and Neck surgery, Department of Surgery and Translational Medicine; University of Florence; Florence Italy
| | - Alberto Deganello
- Academic Clinic of Otolaryngology and Head and Neck surgery, Department of Surgery and Translational Medicine; University of Florence; Florence Italy
| | | | - Oreste Gallo
- Academic Clinic of Otolaryngology and Head and Neck surgery, Department of Surgery and Translational Medicine; University of Florence; Florence Italy
| | - Daniele Vitali
- Academic Clinic of Otolaryngology and Head and Neck surgery, Department of Surgery and Translational Medicine; University of Florence; Florence Italy
| | | | - Christos Georgalas
- Endoscopic Skull Base Center, Department of Otorhinolaryngology, Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
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Yu MH, Chen CL, Liu XL, Xu XW. Differential diagnosis of a carcinoma of the maxillary sinus that resembles a sparganum infection: A case report. Exp Ther Med 2015; 10:1324-1326. [PMID: 26622486 DOI: 10.3892/etm.2015.2661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 06/01/2015] [Indexed: 11/05/2022] Open
Abstract
Primary malignant tumors of the maxillary sinuses are rare. The present study reports the case of a maxillary sinus adenocarcinoma that was misdiagnosed as a frog sparganum infection, and discusses the differential diagnosis between the two diseases. The patient was ultimately diagnosed with a carcinoma of the left maxillary sinus that presented as a progressive mass in the left eye and the maxillary sinus. Eosinophilic infiltration was observed in the subcutaneous tissue, and the patient had experienced previous exposure to undercooked frog. Although an anti-sparganum ELISA was performed and the results were negative, a sparganosis infection was initially diagnosed. However, following the application of anti-sparganosis treatment, no improvements were observed. Histological examination of an orbital mass resection revealed an adenocarcinoma with bone metastases. To the best of our knowledge, the present study is the first to report a maxillary sinus carcinoma misdiagnosed as sparganosis. Therefore, the findings of the current study should be considered in the differential diagnosis between a carcinoma of the maxillary sinus and sparganosis. Avoidance of misdiagnosis at an early stage is crucial for effective diagnosis and treatment of sinonasal malignancies.
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Affiliation(s)
- Mei-Hong Yu
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Chun-Lei Chen
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Xiao-Li Liu
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Xiao-Wei Xu
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
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Rohr AC, Campleman SL, Long CM, Peterson MK, Weatherstone S, Quick W, Lewis A. Potential Occupational Exposures and Health Risks Associated with Biomass-Based Power Generation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:8542-605. [PMID: 26206568 PMCID: PMC4515735 DOI: 10.3390/ijerph120708542] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 07/03/2015] [Accepted: 07/14/2015] [Indexed: 12/19/2022]
Abstract
Biomass is increasingly being used for power generation; however, assessment of potential occupational health and safety (OH&S) concerns related to usage of biomass fuels in combustion-based generation remains limited. We reviewed the available literature on known and potential OH&S issues associated with biomass-based fuel usage for electricity generation at the utility scale. We considered three potential exposure scenarios--pre-combustion exposure to material associated with the fuel, exposure to combustion products, and post-combustion exposure to ash and residues. Testing of dust, fungal and bacterial levels at two power stations was also undertaken. Results indicated that dust concentrations within biomass plants can be extremely variable, with peak levels in some areas exceeding occupational exposure limits for wood dust and general inhalable dust. Fungal spore types, identified as common environmental species, were higher than in outdoor air. Our review suggests that pre-combustion risks, including bioaerosols and biogenic organics, should be considered further. Combustion and post-combustion risks appear similar to current fossil-based combustion. In light of limited available information, additional studies at power plants utilizing a variety of technologies and biomass fuels are recommended.
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Affiliation(s)
- Annette C Rohr
- Electric Power Research Institute, Palo Alto, CA 94304, USA.
| | | | | | | | - Susan Weatherstone
- ON Technologies (Ratcliffe) Ltd., Ratcliffe on Soar, Nottinghamshire, NG11 0EE, UK.
| | - Will Quick
- ON Technologies (Ratcliffe) Ltd., Ratcliffe on Soar, Nottinghamshire, NG11 0EE, UK.
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D'Aguillo CM, Kanumuri VV, Khan MN, Sanghvi S, Patel NR, Baredes S, Eloy JA. Demographics and survival trends of sinonasal adenocarcinoma from 1973 to 2009. Int Forum Allergy Rhinol 2014; 4:771-6. [PMID: 24850785 DOI: 10.1002/alr.21342] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 03/20/2014] [Accepted: 04/08/2014] [Indexed: 07/13/2024]
Abstract
BACKGROUND The purpose of this work was to study the demographics and survival of patients diagnosed with sinonasal adenocarcinoma (SNAC) within the time period of 1973 to 2009 using the Surveillance, Epidemiology, and End Result (SEER) database. METHODS A retrospective cohort study using the U.S. National Cancer Institute's SEER registry was performed to study the demographics and survival for SNAC from 1973 to 2009. Analysis was conducted based on race, gender, and stage. RESULTS In total, 1270 cases of SNAC were analyzed for demographics and survival. Males accounted for 51.6% of cases, while females accounted for 48.4% of cases, amounting to a male to female ratio of 1.06:1.00. Disease specific survival at 5, 10, 15, and 20 years was 65.2%, 50.9%, 40.9%, and 36.5%, respectively. When analyzed by gender, females had higher survival than males, although this difference was not statistically significant. When analyzed by race, the category of other, which encompasses American Indian, Asian, Hispanic, and unknown or unspecified race, was shown to have the best survival, followed by whites and blacks, respectively. CONCLUSION SNAC is a rare tumor classically associated with occupational exposure and carries a variable prognosis. This is the first dedicated large-scale, retrospective analysis of a North American SNAC population. SNAC appears to affect both males and females equally and predominantly affects whites. Patients categorized as other had significantly better survival outcomes, while gender appeared to have no significant effect on survival.
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Affiliation(s)
- Christine M D'Aguillo
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ
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13
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Bruschweiler ED, Hopf NB, Wild P, Huynh CK, Fenech M, Thomas P, Hor M, Charriere N, Savova-Bianchi D, Danuser B. Workers exposed to wood dust have an increased micronucleus frequency in nasal and buccal cells: results from a pilot study. Mutagenesis 2014; 29:201-7. [PMID: 24603450 DOI: 10.1093/mutage/geu003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Wood dust is recognised as a human carcinogen, based on the strong association of wood dust exposure and the elevated risk of malignant tumours of the nasal cavity and paranasal sinuses [sino-nasal cancer (SNC)]. The study aimed to assess genetic damage in workers exposed to wood dust using biomarkers in both buccal and nasal cells that reflect genome instability events, cellular proliferation and cell death frequencies. Nasal and buccal epithelial cells were collected from 31 parquet layers, installers, carpenters and furniture workers (exposed group) and 19 non-exposed workers located in Switzerland. Micronucleus (MN) frequencies were scored in nasal and buccal cells collected among woodworkers. Other nuclear anomalies in buccal cells were measured through the use of the buccal micronucleus cytome assay. MN frequencies in nasal and buccal cells were significantly higher in the exposed group compared to the non-exposed group; odds ratio for nasal cells 3.1 [95% confidence interval (CI) 1.8-5.1] and buccal cells 1.8 (95% CI 1.3-2.4). The exposed group had higher frequencies of cells with nuclear buds, karyorrhectic, pyknotic, karyolytic cells and a decrease in the frequency of basal, binucleated and condensed cells compared to the non-exposed group. Our study confirms that woodworkers have an elevated risk for chromosomal instability in cells of the aerodigestive tract. The MN assay in nasal cells may become a relevant biomonitoring tool in the future for early detection of SNC risk. Future studies should seek to standardise the protocol for MN frequency in nasal cells similar to that for MN in buccal cells.
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Mishra A, Meherotra R. Head and Neck Cancer: Global Burden and Regional Trends in India. Asian Pac J Cancer Prev 2014; 15:537-50. [DOI: 10.7314/apjcp.2014.15.2.537] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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15
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Trail overexpression inversely correlates with histological differentiation in intestinal-type sinonasal adenocarcinoma. Int J Surg Oncol 2013; 2013:203873. [PMID: 24223304 PMCID: PMC3816053 DOI: 10.1155/2013/203873] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 09/19/2013] [Indexed: 12/29/2022] Open
Abstract
Introduction. Despite their histological resemblance to colorectal adenocarcinoma, there is some information about the molecular events involved in the pathogenesis of intestinal-type sinonasal adenocarcinomas (ITACs). To evaluate the possible role of TNF-related apoptosis-inducing ligand (TRAIL) gene defects in ITAC, by investigating the immunohistochemical expression of TRAIL gene product in a group of ethmoidal ITACs associated with occupational exposure. Material and Methods. Retrospective study on 23 patients with pathological diagnosis of primary ethmoidal ITAC. Representative formalin-fixed, paraffin-embedded block from each case was selected for immunohistochemical studies using the antibody against TRAIL. Clinicopathological data were also correlated with the staining results. Results. The immunohistochemical examination demonstrated that poorly differentiated cases showed a higher percentage of TRAIL expressing cells compared to well-differentiated cases. No correlation was found with other clinicopathological parameters, including T, stage and relapses. Conclusion. The relationship between upregulation of TRAIL and poorly differentiated ethmoidal adenocarcinomas suggests that the mutation of this gene, in combination with additional genetic events, could play a role in the pathogenesis of ITAC.
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Affiliation(s)
- Mahmud Mossa-Basha
- Department of Radiology, University of Washington, Seattle, WA 98195, USA.
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Rawal RB, Gore MR, Harvey RJ, Zanation AM. Evidence-based practice: endoscopic skull base resection for malignancy. Otolaryngol Clin North Am 2013; 45:1127-42. [PMID: 22980689 DOI: 10.1016/j.otc.2012.06.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Successful outcomes of endoscopic approaches to benign sinonasal tumors have launched interest in expanding its use for sinonasal malignancy. Because of the heterogeneity and rarity of sinonasal malignancy, evidence for clinical outcomes of endoscopic approaches versus traditional craniofacial resection is low. Using the Oxford Center for Evidence-based Medicine guidelines, we present the existing evidence comparing both techniques for a variety of sinonasal malignancies.
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Affiliation(s)
- Rounak B Rawal
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, 170 Manning Drive, CB 7070, Chapel Hill, NC 27599-7070, USA
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Vivanco Allende B, Perez-Escuredo J, Fuentes Martínez N, Fresno Forcelledo MF, Llorente Pendás JL, Hermsen M. Adenocarcinomas nasosinusales tipo intestinal. Perfil inmunohistoquímico de 66 casos. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2013; 64:115-23. [DOI: 10.1016/j.otorri.2012.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 08/29/2012] [Accepted: 09/04/2012] [Indexed: 01/09/2023]
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Vivanco Allende B, Perez-Escuredo J, Fuentes Martínez N, Fresno Forcelledo MF, Llorente Pendás JL, Hermsen M. Intestinal-type Sinonasal Adenocarcinomas. Immunohistochemical Profile of 66 Cases. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2013. [DOI: 10.1016/j.otoeng.2013.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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20
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Tp53 status as guide for the management of ethmoid sinus intestinal-type adenocarcinoma. Oral Oncol 2013; 49:413-9. [PMID: 23369851 DOI: 10.1016/j.oraloncology.2012.12.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 12/24/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Intestinal-type adenocarcinoma (ITAC) of the ethmoid sinus is a rare, occupational-related tumor. Optimal treatment consists of surgery and radiotherapy, while chemotherapy is still investigational. The molecular profile of ITAC is characterized by the occurrence of TP53 mutations associated with genotoxic agents such as wood dust. We investigated the role of p53 functionality in relation to the primary treatment. MATERIALS AND METHODS We retrospectively reviewed 100 medical charts of consecutive patients with a first diagnosis of ITAC treated at our Institute; 74 patients were evaluable for TP53 analysis. Thirty (41%) were treated from 1991 to 2006 with craniofacial resection followed by radiotherapy (Group A), compared with 44 patients (59%) treated from 1996 to 2006 with cisplatin-based induction chemotherapy (PFL) followed by standard treatment (Group B). RESULTS Five-year OS in Group A was 42%, while in Group B it was 70% (p = 0.041); 5-year DFS in Group A was 40%, while in Group B it was 66%, (p = 0.009) (p = 0.061 and 0.003 at Cox multivariable OS and DFS analyses). Analyzing each group according to p53 functional status, only for Group B patients (who received preoperative chemotherapy) both OS and DFS were in favor of functional p53 (p = 0.023 and p = 0.010, respectively). No impact of p53 functional status as a biomarker was observed in Group A. CONCLUSIONS Functional p53 may predict PFL-chemotherapy efficacy, offering a possible increase in survival when induction chemotherapy is given to a selected population. On the other hand, upcoming innovative approaches should be explored in the presence of non-functional p53.
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Pérez-Escuredo J, Martínez JG, Vivanco B, Marcos CÁ, Suárez C, Llorente JL, Hermsen MA. Wood dust–related mutational profile of TP53 in intestinal-type sinonasal adenocarcinoma. Hum Pathol 2012; 43:1894-901. [DOI: 10.1016/j.humpath.2012.01.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 01/26/2012] [Accepted: 01/27/2012] [Indexed: 10/28/2022]
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Harvey RJ, Winder M, Parmar P, Lund V. Endoscopic skull base surgery for sinonasal malignancy. Otolaryngol Clin North Am 2012; 44:1081-140. [PMID: 21978897 DOI: 10.1016/j.otc.2011.06.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Management of malignant neoplasms of the sinonasal tract and skull base is hampered by the relative low incidence and pathologic diversity of patient presentations. Many studies have reported successful outcomes in the endoscopic management of malignancy since 1996, and these are summarized in this article. Nonsurgical adjuvant therapies are important for locoregional control because surgery occurs in a restricted anatomic space with close margins to critical structures, and distant disease is an ongoing concern in these disorders. There remains a need for collaborative consistent multicenter reporting, and international registries have been established to assist in such efforts.
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Affiliation(s)
- Richard J Harvey
- Department of Otolaryngology/Skull Base Surgery, St Vincent's Hospital, Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia.
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Re M, Magliulo G, Tarchini P, Mallardi V, Rubini C, Santarelli A, Lo Muzio L. p53 and BCL-2 over-expression inversely correlates with histological differentiation in occupational ethmoidal intestinal-type sinonasal adenocarcinoma. Int J Immunopathol Pharmacol 2011; 24:603-9. [PMID: 21978692 DOI: 10.1177/039463201102400306] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Despite their histological resemblance to colorectal adenocarcinoma, there is little information on the molecular events involved in the pathogenesis of intestinal-type sinonasal adenocarcinoma (ITACs). The aim of this paper is to evaluate the possible role of TP53 and Bcl-2 gene defects in ITAC by investigating the immunohistochemical expression of TP53 and Bcl-2 gene products in a group of ethmoidal ITACs associated with occupational exposure. A retrospective study on 15 patients with pathological diagnosis of primary ethmoidal ITAC was conducted. Representative formalin-fixed, paraffin wax-embedded block from each case was selected for immunohistochemical studies using the antibodies against p53 and Bcl-2. Clinical-pathological data were also correlated with the staining results. The results of immunohistochemical examination demonstrated that poorly differentiated cases showed a higher percentage of p53 and Bcl-2 expressing cells in comparison to well-differentiated cases. No correlation was found with other clinico-pathological parameters, including T, stage and relapses. The relationship between up-regulation of p53 and Bcl-2 and poorly differentiated ethmoidal adenocarcinoma suggests a role of these genes, in combination with additional genetic events, in the pathogenesis of ITAC.
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Affiliation(s)
- M Re
- Department of Otorhinolaryngology, Marche Polytechnic University, Ancona, Italy
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Cantu G, Solero CL, Mariani L, Lo Vullo S, Riccio S, Colombo S, Pompilio M, Perrone F, Formillo P, Quattrone P. Intestinal type adenocarcinoma of the ethmoid sinus in wood and leather workers: a retrospective study of 153 cases. Head Neck 2011; 33:535-42. [PMID: 20665741 DOI: 10.1002/hed.21485] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The purpose of our study was to identify the role of work exposure to organic dusts in patients with malignant paranasal sinus tumors. METHODS We analyzed all patients surgically treated for a malignant paranasal sinus tumor at our institution between 1987 and 2006. All patients were specifically asked about their occupational history. The tumor site was classified as maxillary or ethmoid sinus. Adenocarcinomas were divided into intestinal type (ITAC) and non-ITAC. RESULTS The sample included 345 patients with ethmoid sinus and 301 maxillary sinus. Regarding the ethmoid sinus, we found an exposure to organic dusts in 148 of 153 patients with ITAC, in 3 of 16 patients with non-ITAC adenocarcinoma, and in 10 of 176 patients with other tumors. Regarding the maxillary sinus, we found an exposure in 1 of 20 patients with non-ITAC adenocarcinoma and in 4 of 281 patients with other histologies. CONCLUSION Our study demonstrates that only ethmoid ITACs have an indisputable relationship with the exposure to organic dusts.
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Affiliation(s)
- Giulio Cantu
- Cranio-Maxillo-Facial Unit, Fondazione I.R.C.C.S. Istituto Nazionale dei Tumori, Milan, Italy.
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Lund VJ, Chisholm EJ, Takes RP, Suárez C, Mendenhall WM, Rinaldo A, Llorente JL, Terhaard CHJ, Rodrigo JP, Maughan E, Ferlito A. Evidence for treatment strategies in sinonasal adenocarcinoma. Head Neck 2011; 34:1168-78. [PMID: 21523846 DOI: 10.1002/hed.21770] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2011] [Indexed: 11/10/2022] Open
Abstract
Adenocarcinomas of various types account for 10% to 20% of all primary malignant neoplasms of the nasal cavity and paranasal sinuses. There is a general consensus that the optimal treatment of adenocarcinoma is surgery and postoperative radiotherapy. The purpose of this report was to review the results of this combined treatment as well as other treatment strategies and their outcome. Most series present outcome data from a heterogeneous group of patients, with a wide variety of tumor subtypes presenting at differing stages, who received a variety of treatment strategies. Surgical excision remains the treatment of choice. The choice of approach is determined by what will best allow complete excision of the disease. Endoscopic techniques, if feasible for complete removal of the tumor, offer results comparable to those of external approaches with lower morbidity. Although clear evidence to support the use of radiotherapy in sinonasal adenocarcinoma is difficult to obtain, local control rates of combined treatment strategies for advanced cases are comparable to less advanced cases with surgery alone, suggesting a positive role for postoperative radiotherapy. However, the importance of thorough surgical resection should be stressed.
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Affiliation(s)
- Valerie J Lund
- Ear Institute, University College London, London, United Kingdom
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Nicolai P, Villaret AB, Bottazzoli M, Rossi E, Valsecchi MG. Ethmoid adenocarcinoma--from craniofacial to endoscopic resections: a single-institution experience over 25 years. Otolaryngol Head Neck Surg 2011; 145:330-7. [PMID: 21515803 DOI: 10.1177/0194599811403873] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To identify factors that influence hospitalization time, complications, and prognosis of patients with ethmoid adenocarcinoma treated with different surgical techniques. DESIGN Single-institution retrospective review. SETTING Academic tertiary care center. PATIENTS Sixty-seven patients with ethmoid adenocarcinoma treated from January 1985 to August 2009 were retrospectively evaluated. Surgical treatment included endoscopic resection (n = 12), endoscopic resection with transnasal craniectomy (n = 17), cranioendoscopic resection (n = 9), external approaches limited to the ethmoid (n = 11), and craniofacial resection (n = 18). MAIN OUTCOME MEASURES A Cox model was adopted to relate time to death to previous treatment, pT category, grade, and surgical technique. The impact of the same variables on hospitalization time and risk of complications was assessed by linear regression and logistic regression, respectively. RESULTS The risk of complications increased for pT4a-b lesions (P = .02) and craniofacial resection (P = .01). Hospitalization time increased by 6.3 days for cranioendoscopic resection (P = .03) and by 11.7 days for craniofacial resection (P < .001). Three- and 5-year overall survivals were 68.0% (standard error = 5.8%) and 48.4% (standard error = 6.9%). Three-year survival was 76.62% and 51.81% for previously untreated and treated patients, respectively, and it was 92.98% and 33.33% in patients treated with endoscopic techniques and craniofacial resection, respectively. Multivariate analysis showed that previous treatment (hazard ratio of death = 3.9, P = .01) and craniofacial resection (HR = 5.16, P = .05) were mainly associated with survival. CONCLUSIONS Endoscopic techniques, in properly selected patients, were associated with a favorable oncologic outcome and a statistically significant reduction in both complication rate and hospitalization time. This study supports the role of endoscopic techniques in surgical treatment of ethmoid adenocarcinoma.
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Affiliation(s)
- Piero Nicolai
- Department of Otorhinolaryngology, University of Brescia, Brescia, Italy
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Vivanco B, Llorente JL, Perez-Escuredo J, Alvarez Marcos C, Fresno MF, Hermsen MA. Benign lesions in mucosa adjacent to intestinal-type sinonasal adenocarcinoma. PATHOLOGY RESEARCH INTERNATIONAL 2011; 2011:230147. [PMID: 21559194 PMCID: PMC3090045 DOI: 10.4061/2011/230147] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Revised: 02/15/2011] [Accepted: 02/17/2011] [Indexed: 11/20/2022]
Abstract
Occupational exposure to wood dust is a strong risk factor for the development of intestinal-type sinonasal adenocarcinoma (ITAC); however, knowledge on possible precursor lesions or biomarkers is limited. Fifty-one samples of tumor-adjacent mucosa and 19 control samples of mucosa from the unaffected fossa of ITAC patients were evaluated for histological changes and p53 protein expression. Mild dysplasia was observed in 14%, cuboidal metaplasia in 57%, intestinal metaplasia in 8%, squamous metaplasia in 24%, and cylindrocellular hyperplasia in 53% of cases. P53 immunopositivity was generally weak occurring most frequently in squamous metaplasia. Wood dust etiology did not appear of influence on the histological changes, but p53 showed a tendency for higher positivity. Dysplasia adjacent to tumor was indicative of subsequent development of recurrence. In conclusion, precursor lesions do occur in mucosa adjacent to ITAC. This is clinically important, because it may justify the screening of high-risk individuals such as woodworkers.
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Affiliation(s)
- Blanca Vivanco
- Department of Pathology, Hospital Universitario Central de Asturias, Celestino Villamil s/n, Oviedo, 33006 Asturias, Spain
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Devaiah AK, Lee MK. Endoscopic skull base/sinonasal adenocarcinoma surgery: what evidence exists? Am J Rhinol Allergy 2010; 24:156-60. [PMID: 20338117 DOI: 10.2500/ajra.2010.24.3449] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND This study reviewed the published outcomes literature on endoscopic or endoscopic-assisted treatment of sinonasal and skull base adenocarcinoma (SSBA). A systematic literature review was performed. METHODS A PubMed search of English language articles on endoscopic or endoscopic-assisted SSBA was performed. Each article was examined for patient data and outcomes for analysis. RESULTS Sixteen articles (150 retrospective cases) using endoscopic or endoscopic-assisted SSBA were identified. Three (19%) reported at least 15 cases of adenocarcinoma with 5-year survival ranging from 53 to 83%. In all identified studies, five (31%) reported adenocarcinoma-specific survival statistics and eight (50%) provided complete patient information. Adjuvant therapy was used in 12 studies (75%), with details outlined in 6 (38%) articles, accounting for 52 of 74 cases (70% of those patients and 35% overall). Adenocarcinoma-specific follow-up was reported in only nine studies (56%); four of these nine articles had a median/mean follow-up time of <3 years. Six articles (38%) used American Joint Committee on Cancer guidelines and four articles (25%) used International Union Against Cancer guidelines. The remaining six articles (38%) did not report on the stage of treated tumors. Four articles (25%) reported length of hospital stay and eight (50%) reported complication data. Three studies comprising 61 cases (41% of overall patients) recorded disease status, tumor stage, site involvement, and complication rates for each patient. CONCLUSION From the existing body of data, one can not conclude that endoscopic methods are superior or inferior to open methods, but there is growing evidence that this is an efficacious technique. Future studies should have emphasis on detailed, prospective reporting.
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Affiliation(s)
- Anand K Devaiah
- Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine, Boston, Massachusetts, USA.
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Abstract
Although squamous cell carcinoma is the most frequent malignant diagnosis made with upper aerodigestive tract specimens, a myriad of neoplasms can occur throughout the area. Very uncommonly, one encounters adenocarcinomas that cannot be better classified as salivary gland-type neoplasia. This manuscript reviews these tumors, including sinonasal intestinal-type adenocarcinomas, sinonasal low-grade and high-grade nonintestinal adenocarcinomas and nasopharyngeal papillary adenocarcinomas. Clinical, histologic, and immunohistochemical features and differential diagnoses are discussed.
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de Gabory L, Maunoury A, Maurice-Tison S, Merza Abdulkhaleq H, Darrouzet V, Bébéar JP, Stoll D. Long-Term Single-Center Results of Management of Ethmoid Adenocarcinoma: 95 Patients over 28 Years. Ann Surg Oncol 2010; 17:1127-34. [DOI: 10.1245/s10434-010-0933-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Indexed: 11/18/2022]
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Characterization of initial clinical symptoms and risk factors for sinonasal adenocarcinomas: results of a case-control study. Int Arch Occup Environ Health 2009; 83:631-8. [PMID: 19885670 DOI: 10.1007/s00420-009-0479-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 10/16/2009] [Indexed: 11/27/2022]
Abstract
PURPOSE Sinonasal adenocarcinoma is a rare cancer, frequently associated with occupational exposure to inhalable wood dust. Among the EU member States, Germany was reported to have the highest number of exposed workers. Location and long latency make early diagnosis difficult. This case-control study was aimed at assessing potential risk factors and at characterizing initial clinical symptoms, both serving as matrix to identify persons at increased risk and to improve management of this cancer. METHODS Of 58 patients, 31 diagnosed with sinonasal adenocarcinoma (cases) between 1973 and 2007 were identified and underwent standardized interview on clinical data. A total of 85 patients diagnosed over the same period with carcinoma of the oral cavity served as controls. RESULTS The ethmoid was confirmed as the predominant site of adenocarcinoma associated with wood dust exposure, whereas the nasal cavity was most commonly affected in patients denying any exposure to wood dust. Cases were significantly engaged in mainly woodworking occupations compared to controls. The main initial clinical symptoms were nasal obstruction 6 months (71%) and epistaxis 4 years (41.9%) prior to diagnosis. Hardwood dust from beech and oak proved to be the most common occupational exposure, with a mean exposure period of 32.3 years and a latency of 43.5 (34-58) years. CONCLUSIONS Our investigation confirms the importance of regular screenings for persons exposed to wood dust even years after the end of occupational or private exposure. Banal clinical symptoms such as epistaxis and nasal obstruction might be predictive, requiring early and thorough investigation.
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Poizat F, Gonzalez AM, Raynaud P, Baldet P, Garrel R, Crampette L, Costes V. [Adenocarcinomas of nasal cavities and paranasal sinuses: Diagnostic pitfalls in sinonasal glandular lesions]. Ann Pathol 2009; 29:286-95. [PMID: 19900634 DOI: 10.1016/j.annpat.2009.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Accepted: 07/22/2009] [Indexed: 01/05/2023]
Abstract
Among primitive adenocarcinoma of nasal cavity and paranasal sinus, the 2005 WHO classification distinguishes two main categories: intestinal type adenocarcinoma (ITAC) and low-grade non-intestinal adenocarcinoma, entities with different clinical and epidemiological characteristics. Low-grade adenocarcinoma shows a respiratory type phenotype (CK20-/CK7+/CDX2-/villin-) and ITACs, an intestinal type profile (CK20+/CK7-/CDX2+/villin+). Because of histological, ultrastructural and phenotypical similarities between ITAC and colorectal adenocarcinomas, several studies have discussed a possible common pathway in carcinogenesis. But the review of literature shows conflicting results, suggesting different pathways of pathogenesis. Differential diagnoses of sinonasal intestinal-type adenocarcinoma are mainly respiratory epithelial adenomatoid hamartomas, inverted schneiderian papillomas, salivary glands-type carcinoma and more rarely metastasis of adenocarcinoma.
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Affiliation(s)
- Flora Poizat
- Service d'anatomie et cytologie pathologique, hôpital Gui-de-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.
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El Ayoubi A, Poizat F, Garrel R, Costes V, Guerrier B, Essakalli L, Kzadri M, Crampette L. Les adénocarcinomes nasosinusiens revisités. Intérêt pronostique de la classification histologique OMS 2005. ACTA ACUST UNITED AC 2009; 126:175-81. [DOI: 10.1016/j.aorl.2009.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2009] [Accepted: 06/04/2009] [Indexed: 11/28/2022]
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Georgel T, Jankowski R, Henrot P, Baumann C, Kacha S, Grignon B, Toussaint B, Graff P, Kaminsky MC, Geoffrois L, Vignaud JM. CT assessment of woodworkers' nasal adenocarcinomas confirms the origin in the olfactory cleft. AJNR Am J Neuroradiol 2009; 30:1440-4. [PMID: 19541776 DOI: 10.3174/ajnr.a1648] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Endoscopic endonasal surgery let us observe that woodworkers' nasal adenocarcinomas originate in the olfactory cleft. Our aim was the identification of CT imaging features that corroborate the olfactory cleft as the site of origin for woodworkers' adenocarcinoma. MATERIALS AND METHODS We designed a retrospective study to compare CT scans of 27 unilateral olfactory cleft adenocarcinomas with 30 cases of nasosinusal polyposis (NSP) and 33 healthy sinus controls. Enlargement of the olfactory cleft, lateralization of the ethmoidal turbinate wall, and contralateral bulging of the nasal septum were measured on coronal scans passing through crista galli and posterior half of both ocular globes. Comparisons have been performed by using analysis of variance and the Bonferroni procedure. RESULTS The nasal septum was significantly bulging across the midline in adenocarcinoma (4.6 +/- 3 mm; range, -0.1-13.7 mm) compared with NSP (0.7 +/- 1 mm; range, -2.1-2.3 mm) or healthy sinus controls (0.5 +/- 1 mm; range, -1.2-2 mm) (P < .001). The olfactory cleft was significantly wider in adenocarcinoma (15.1 +/- 4.5 mm; range, 8.6-25.7 mm) than in NSP (3.6 +/- 0.4 mm; range, 2.8-4.6 mm) or healthy sinus controls (3.3 +/- 0.7 mm; range, 1.4-4.6 mm). The ethmoidal labyrinth width was significantly smaller on the pathologic side in adenocarcinoma (7.2 +/- 2.7 mm; range, 3.2-14.2 mm) than in the control groups (P < .001). Whereas the angle between the conchal lamina and vertical midline was close to zero degrees in NSP (0.03 +/- 2.25 degrees ; range, -5 degrees -3 degrees ) and healthy sinus controls (0.45 +/- 2.13 degrees , range, -5 degrees -5 degrees ), it reached 39.76 +/- 13.83 degrees (P < .001) in adenocarcinoma. CONCLUSIONS Radiologists should suspect nasal adenocarcinoma on sinus CT scans showing a unilateral expanding opacity of the olfactory cavity.
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Affiliation(s)
- T Georgel
- Department of Otorhinolaryngology, CHU Nancy, Nancy, France
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Abstract
Die Gesichtsmitte (der Bezirk zwischen Oberlippe und Stirn) entwickelt sich zwischen der 4. und 8. Schwangerschaftswoche. [ 220] Der Stirnfortsatz bildet sich währen der 4. postovulatorischen Woche, aus ihm gehen die oberen und mittleren Anteile des Gesichts hervor. Die Oberkiefer- und Nasenwülste entwickeln sich unterhalb des Stirnfortsatzes. Am Ende der 4. Woche bilden zwei oberflächliche Verdickungen der Nasenwülste die Riechplakoden, die ektodermaler Herkunft sind und aus denen der Epithelbelag der Nasenhöhle und Nasennebenhöhlen hervorgeht. Die Plakoden stülpen sich ein und bilden die Riechgruben, aus denen die vorderen Choanen (Nasenlöcher) und weniger oberflächlich die primitiven hinteren Choanen entstehen. Die medialen Nasen- und Stirnfortsätze bilden das Nasenseptum, die Stirnknochen, Nasenknochen, die Siebbeinzellen- Komplexe und die oberen Schneidezähne. Die lateralen Nasen- und Oberkieferfortsätze vereinigen sich zur Bildung des Philtrum und der Columella. Das knorpelige Nasenskelet bildet sich während der 7. und 8. postovulatorischen Woche tief unterhalb der Nasen- und Stirnbeinknochen aus dem Chondrocranium. Die Nasennebenhöhlen entwickeln sich in der 6. Fetalwoche aus den lateralen Nasenwänden, und ihr Wachstum setzt sich nach der Geburt während des gesamten Kindes- und Jugendalters fort.
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Affiliation(s)
- Antonio Cardesa
- Department of Pathological Anatomy, Hospital Clinic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spanien
| | - Pierre Rudolph
- Pathologisches Institut, Mühlenstr. 31, 45759 Recklinghausen, Deutschland
| | - Thomas Mentzel
- Dermatopathologische Gemeinschaftspraxis, Siemensstr. 6/1, 88048 Friedrichshafen, Deutschland
| | - Pieter J. Slootweg
- Department of Pathology HP 437, University Medical Center St. Radbound, P.O. Box 9101, 6500 Nijmegen, Niederlande
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Llorente JL, Núñez F, Rodrigo JP, Fernández León R, Alvarez C, Hermsen M, Suárez C. [Sinonasal adenocarcinomas: our experience]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2008; 59:235-8. [PMID: 18501159 DOI: 10.1016/s2173-5735(08)70229-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
INTRODUCTION AND OBJECTIVES Sinonasal adenocarcinoma is a rare epithelial cancer of the nasal cavities and paranasal sinuses and exposure to sawdust particles is a strong aetiological factor. MATERIAL AND METHOD Seventy-nine patients (78 men and 1 woman) operated on between 1986 and 2002 were studied. RESULTS In 62 patients (78.5 %) there was a history of exposure to wood dust. The clinical factors presenting statistical significance in the multivariate analysis with prognosis were: the exclusive invasion of the middle concha (as good prognosis), recurrence and invasion of the dura mater (as bad prognosis). The actuarial survival rate was 36 % at 5 years falling to 28 % at 10 years. CONCLUSIONS Exposure to wood dust, even over a short period of time, must be considered as a high risk factor for the development of a sinonasal adenocarcinoma. This tumour must be ruled out in all patients suffering any type of sinonasal pathology.
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Affiliation(s)
- José Luis Llorente
- Servicio de Otorrinolaringología y Unidad de Base de Cráneo, Instituto Universitario de Oncología del Principado de Asturias, Hospital Central Universitario de Asturias, Oviedo, Asturias, España.
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Llorente JL, Pérez-Escuredo J, Alvarez-Marcos C, Suárez C, Hermsen M. Genetic and clinical aspects of wood dust related intestinal-type sinonasal adenocarcinoma: a review. Eur Arch Otorhinolaryngol 2008; 266:1-7. [PMID: 18560862 DOI: 10.1007/s00405-008-0749-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2008] [Accepted: 06/02/2008] [Indexed: 12/01/2022]
Abstract
Intestinal-type sinonasal adenocarcinoma (ITAC) is a rare epithelial cancer of the nasal cavities and paranasal sinuses. Exposure to wood dust particles is a strong etiological factor making it a professional disease. These tumors are locally aggressive with frequent local recurrences in up to 50% of cases. Metastasis to regional lymph nodes and distant metastasis are less frequent (10%). Invasion of the duramater and local recurrence are frequent and the major cause of death. Standard therapeutic modalities include surgery followed by radiotherapy in advanced stages, sometimes with chemotherapy treatment. The molecular genetic mechanisms underlying the development and progression of this tumor is not understood. Histopathologically, ITAC resembles colorectal adenocarcinoma and have directed early genetic studies to search for similar genetic alterations. Recently, genome-wide studies have identified a recurrent pattern of chromosomal aberrations. This review aims to describe the clinico-pathological characteristics of this relatively unknown tumor and to summarize the knowledge on genetic and chromosomal analyses up to the present time.
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Affiliation(s)
- José Luis Llorente
- Department of Otolaryngology, Instituto Universitario de Oncología del Principado de Asturias, Edificio H Covadonga 1 feminine Planta Centro, Lab 2, Hospital Universitario Central de Asturias, Celestino Villamil s/n, 33006, Oviedo, Spain
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Luis Llorente J, Núñez F, Pablo Rodrigo J, Fernández León R, Álvarez C, Hermsen M, Suárez C. Adenocarcinomas nasosinusales: nuestra experiencia. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2008. [DOI: 10.1016/s0001-6519(08)73301-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
OBJECTIVE To determine risk factors and evaluate the treatment of ethmoid adenocarcinoma. Epidemiologic data were recorded and compared with the literature. MATERIALS AND METHODS A multicenter and retrospective study. The medical records of 418 patients who had presented with ethmoid adenocarcinoma at 11 French hospitals from 1976 to 2001 were analyzed to determine the clinical characteristics and treatment of the disease. RESULTS The gender ratio was 2.8 men per 1 woman. Toxic exposure was classic for this lesion, exposure to wood and leather for most cases. The mean age was 63 years (range 31-91). Symptoms were nonspecific and based on clinical rhinologic signs. Nasal endoscopy after mucosal retraction was found useful to evaluate the extension of the lesion and to perform biopsies. Computed tomography scan and magnetic resonance imagery must be carried out prior to treatment to define extra nasal extension. The survival rate was significantly influenced by the size of the lesion (T4, N+) and extension to brain or dura. Surgery with postoperative radiotherapy remains the treatment of choice. Total excision must be a major priority, as confirmed in our series. CONCLUSION This retrospective study was, to our knowledge, the largest ever reported in the literature. This series confirmed the risk factor of this lesion as well as the lesion's influence on the survival rate. Surgery is the most important part of the treatment. Local recurrences were responsible for the poor prognosis of this lesion.
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Abstract
OBJECTIVES To discuss common sinonasal malignancies with emphasis on squamous cell carcinoma and describe preoperative and postoperative magnetic resonance imaging evaluation for these lesions. METHODS Literature and institutional review. RESULTS Because of the large variety of the normal cell population, a variety of malignant neoplasms may occur in the sinonasal tract. For a large number of reasons, they are often advanced at the time of diagnosis and are difficult to treat given the complex anatomy of the sinonasal region and its proximity to critical structures. Magnetic resonance imaging is a vital tool in the diagnosis of these lesions and is used in conjunction with computed tomography to precisely delineate the extent of these neoplasms. Involvement of the skull base, the orbits, the intracranial compartment, and potential perineural spread of tumor can influence treatment options. Magnetic resonance is essential to evaluate these tumors. CONCLUSIONS Magnetic resonance plays a vital role in the diagnosis of sinonasal neoplasms and is essential to accurately determine the precise extent of these tumors for treatment planning. It is also a useful tool in tumor surveillance.
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Affiliation(s)
- Prashant Raghavan
- Department of Neuroradiology, University of Virginia Health Systems, Charlottesville, VA, USA.
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41
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Primary carcinoma of the frontal sinus: a case report and a review of literature. Eur Arch Otorhinolaryngol 2007; 265:593-7. [DOI: 10.1007/s00405-007-0491-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2007] [Accepted: 10/04/2007] [Indexed: 11/26/2022]
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Update on sinonasal adenocarcinoma: classification and advances in immunophenotype and molecular genetic make-up. Head Neck Pathol 2007; 1:38-43. [PMID: 20614280 PMCID: PMC2807499 DOI: 10.1007/s12105-007-0025-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2007] [Accepted: 08/08/2007] [Indexed: 10/22/2022]
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Abstract
The lateral rhinotomy approach is one of the most commonly used techniques for exploration of the difficult sinonasal masses. Though endoscopic advances have progressed rapidly since last few years, but the excellent exposure provided by the lateral rhinotomy approach makes it suitable for resection of sinonasal masses with extensive spread. Our study is an attempt to establish the different spectra of pathologies encountered in the sinonasal region, which were removed by the lateral rhinotomy approach and to establish its importance in the context of modern rhinological surgeries.
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Affiliation(s)
- Saumik Das
- Calcutta National Medical College and Hospital, 24 Gorachand Road, Kolkata, India
- Ce 166 Sector 1, Salt Lake City Kolkata, 700 064 India
| | - Pranabashish Banerjee
- Calcutta National Medical College and Hospital, 24 Gorachand Road, Kolkata, India
- Ce 166 Sector 1, Salt Lake City Kolkata, 700 064 India
| | - Anup Das
- Calcutta National Medical College and Hospital, 24 Gorachand Road, Kolkata, India
- Ce 166 Sector 1, Salt Lake City Kolkata, 700 064 India
| | - Ramanuj Sinha
- Calcutta National Medical College and Hospital, 24 Gorachand Road, Kolkata, India
- Ce 166 Sector 1, Salt Lake City Kolkata, 700 064 India
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45
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Gras Cabrerizo JR, García AS, Montserrat i Gili JR, Dotú CO. Revision of Carcinomas in Paranasal Sinus. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2007. [DOI: 10.1016/s2173-5735(07)70347-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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46
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Nazar G, González MV, García JM, Llorente JL, Rodrigo JP, Suárez C. Amplification of CCND1, EMS1, PIK3CA, and ERBB oncogenes in ethmoid sinus adenocarcinomas. Otolaryngol Head Neck Surg 2006; 135:135-9. [PMID: 16815198 DOI: 10.1016/j.otohns.2006.01.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2005] [Accepted: 01/25/2006] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Assess the amplification of CCND1, EMS1, PIK3CA, ERBB1, and ERBB2 oncogenes in ethmoid sinus adenocarcinomas. STUDY DESIGN AND SETTING Tissue samples from 13 primary ethmoid adenocarcinomas and 2 recurrences were studied at Hospital Central de Asturias, Oviedo, Spain, between July 1998 and February 2002. A semiquantitative evaluation of CCND1, EMS1, PIK3CA, ERBB1, and ERBB2 amplification was performed by multiplex polymerase chain reaction. RESULTS Three (23%) cases presented CCND1 amplification, one of them with a concurrent PIK3CA amplification. EMS1 was amplified in the 2 studied recurrences. ERBB1 was amplified in 1 case (8%), whereas none presented ERBB2 amplification. Oncogenic amplifications were only detected in advanced (stage III) tumors; however, no prognostic value could be shown for them. CONCLUSIONS CCND1, EMS1, PIK3CA, and ERBB1 amplifications are uncommon and appear to be late events in the development of ethmoid sinus adenocarcinoma. SIGNIFICANCE New information on the carcinogenesis of this infrequent sinonasal tumor is presented.
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Affiliation(s)
- Gonzalo Nazar
- Department of Otolaryngology, Hospital Central de Asturias, Oviedo, Spain.
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47
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Affiliation(s)
- Antonio Cardesa
- grid.5841.80000000419370247Department of Pathological Anatomy, Hospital Clinic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain
| | - Pieter J. Slootweg
- grid.10417.330000000404449382Department of Pathology, University Medical Center St. Radboud, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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Iannetti G, Valentini V, Rinna C, Ventucci E, Marianetti TM. Ethmoido-Orbital Tumors: Our Experience. J Craniofac Surg 2005; 16:1085-91. [PMID: 16327559 DOI: 10.1097/01.scs.0000164332.81428.ba] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
No data in the literature report the specific invasion of the orbit from ethmoidal tumors, although such a pattern of involvement of the orbit frequently occurs because of the thin lamina papyracea separating the two structures. From January 1986 to January 2003, 38 patients with untreated primary ethmoidal malignancies were observed at the Unit of Maxillo-Facial Surgery of the University "La Sapienza" in Rome. Personal data were obtained from review of the personal clinical file of each. Orbital invasion was present in 24 patients with ethmoidal malignancy. Three stages of orbital invasion were identified. The average overall survival, with the Kaplan-Meyer method, was 61.4% after 1 year and 51.1% at 5 and 10 years. Intracranial involvement is the main element for short-term negative prognosis. Orbital exenteration is fundamental if grade III orbital invasion occurs because it ensures an improvement of the disease-free survival.
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Affiliation(s)
- Giorgio Iannetti
- Department of Maxillo-Facial Surgery, University of Rome La Sapienza, Rome, Italy
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49
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Yom SS, Rashid A, Rosenthal DI, Elliott DD, Hanna EY, Weber RS, El-Naggar AK. Genetic analysis of sinonasal adenocarcinoma phenotypes: distinct alterations of histogenetic significance. Mod Pathol 2005; 18:315-9. [PMID: 15492756 DOI: 10.1038/modpathol.3800315] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Sinonasal adenocarcinomas, a relatively rare entity, are composed of distinctly different morphologic subtypes with variable biological behavior. To investigate the genetic events associated with their development and clinicopathologic features, we analyzed the alterations in K-ras, APC, beta-catenin, hMLH1 and hMSH2 and p53 genes expression in a cohort of 15 primary tumors comprising the two main sinonasal adenocarcinoma subtypes (enteric and seromucinous). The patients consisted of 13 men and two women, who ranged in age from 50 to 87 years. Tumors were predominantly located in the ethmoid sinus. Eight tumors were Enteric-type, and seven were seromucinous type. Nine patients were smokers and four were nonsmokers; and no information was available on two patients. Two of the eight enteric-type, had K-ras mutation at codons 12A and 12B, and one showed microsatellite instability at BAT-25. Two patients with enteric-type tumors had a history of wood-dust exposure, and one had a K-ras mutation at 12A codon as well as p53 overexpression. No patients with the seromucinous type had any genetic abnormalities, except for overexpression of p53 in two tumors. Our results show that (1) a subset of enteric-type sinonasal adenocarcinoma shares certain genetic alterations with colonic adenocarcinomas, (2) the seromucinous-type sinonasal adenocarcinoma lacks alterations and may develop through a different pathway, (3) high p53 expression is associated with aggressive tumor features in both subtypes and (4) the enteric-type runs a more malignant course than the seromucinous counterpart.
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Affiliation(s)
- Sue S Yom
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Abecasis J, Viana G, Pissarra C, Pereira T, Fonseca I, Soares J. Adenocarcinomas of the nasal cavity and paranasal sinuses: a clinicopathological and immunohistochemical study of 14 cases. Histopathology 2005; 45:254-9. [PMID: 15330803 DOI: 10.1111/j.1365-2559.2004.01949.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS To evaluate the clinicopathological profile of 14 cases of nasal and paranasal sinusal adenocarcinoma, and to assess the usefulness of immunohistochemistry in the differential diagnosis of primary and metastatic intestinal-type adenocarcinoma. METHODS AND RESULTS Fourteen cases of nasal and paranasal adenocarcinoma, treated at IPOFG, Lisbon, between 1976 and 2002, were studied. Clinical records were reviewed and expression of cytokeratin (CK)7 and CK20 and of neuroendocrine markers was evaluated. The male : female ratio was 3 : 1, and the mean age of the patients was 65.3 years. Ten cases occurred in the paranasal sinuses. There was a history of professional exposure to dust in three patients. Twelve cases were high-grade intestinal type adenocarcinomas (ITAC) and two were low-grade. CK7 was present in 2/9 ITAC cases and CK20 in 8/9 ITAC and in cases of mixed and mucinous histology. All high-grade cases showed neuroendocrine differentiation. Seven of the 12 patients with high-grade adenocarcinoma died of the disease, with a mean follow-up of 47.4 months. CONCLUSIONS Nasal and paranasal adenocarcinoma mostly occurs in men in the 7th decade. ITAC is the most frequent histological type. The pattern of CK7/CK20 was not useful in the distinction between primary and metastatic intestinal adenocarcinoma. However, in the former, neuroendocrine differentiation proved to be a valuable tool in that distinction.
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Affiliation(s)
- J Abecasis
- Serviço Universitário de Anatomia Patológica, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
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