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Updates in management strategies of locally advanced sinonasal malignancy. Curr Opin Otolaryngol Head Neck Surg 2023; 31:39-44. [PMID: 36856185 DOI: 10.1097/moo.0000000000000866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
PURPOSE OF REVIEW Sinonasal tumors are a rare heterogenous group of pathologies with poor prognosis. In recent years better definition and understanding of histology, molecular classification, biological behavior and advances in therapy have resulted in improved prognosis. The purpose of this review is to give an updated summary of the recent advances in treatment, and where relevant, with references to pathology classifications. RECENT FINDINGS Recent publications highlight the role of induction chemotherapy and advances in radiotherapy in advanced cancers. In addition, better understanding of genomics and histology specific treatment algorithms has led to more tailored treatment approaches. The role of immunotherapy and targeted therapy are yet to be explored. SUMMARY This review gives an up to date summary of the advances in contemporary management strategies for locally advanced sinonasal malignancies and can serve as a guide for researchers and clinicians.
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Lucidi D, Cantaffa C, Miglio M, Spina F, Alicandri Ciufelli M, Marchioni A, Marchioni D. Tumors of the Nose and Paranasal Sinuses: Promoting Factors and Molecular Mechanisms-A Systematic Review. Int J Mol Sci 2023; 24:ijms24032670. [PMID: 36768990 PMCID: PMC9916834 DOI: 10.3390/ijms24032670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/22/2023] [Accepted: 01/29/2023] [Indexed: 02/01/2023] Open
Abstract
Sinonasal neoplasms are uncommon diseases, characterized by heterogeneous biological behavior, which frequently results in challenges in differential diagnosis and treatment choice. The aim of this review was to examine the pathogenesis and molecular mechanisms underlying the regulation of tumor initiation and growth, in order to better define diagnostic and therapeutic strategies as well as the prognostic impact of these rare neoplasms. A systematic review according to Preferred Reporting Items for Systematic Review and Meta-Analysis criteria was conducted between September and November 2022. The authors considered the three main histological patterns of sinonasal tumors, namely Squamous Cell Carcinoma, Intestinal-Type Adenocarcinoma, and Olfactory Neuroblastoma. In total, 246 articles were eventually included in the analysis. The genetic and epigenetic changes underlying the oncogenic process were discussed, through a qualitative synthesis of the included studies. The identification of a comprehensive model of carcinogenesis for each sinonasal cancer subtype is needed, in order to pave the way toward tailored treatment approaches and improve survival for this rare and challenging group of cancers.
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Affiliation(s)
- Daniela Lucidi
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
| | - Carla Cantaffa
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
- Correspondence: ; Tel.: +39-3385313850; Fax: +39-0594222402
| | - Matteo Miglio
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
| | - Federica Spina
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
| | - Matteo Alicandri Ciufelli
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
| | - Alessandro Marchioni
- Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University Hospital of Modena, 41124 Modena, Italy
| | - Daniele Marchioni
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
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Adenosquamous Carcinomas and Mucinous Adenocarcinoma of the Minor Salivary Glands: Immunohistochemical and Molecular Insights. JOURNAL OF MOLECULAR PATHOLOGY 2022. [DOI: 10.3390/jmp3040023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
There is confusion about the diagnosis, histogenesis and taxonomical efforts regarding adenosquamous carcinomas (ASCs) and mucinous adenocarcinomas (MACs), especially with calls for reconsidering the nature of high-grade mucoepidermoid carcinoma (MEC). This study aims to compare the genetic profiles of ASCs and MACs that have been previously reported in the literature and investigate if either ASC or MAC is closer in genetic mutations to high-grade MEC. Systematic searches in the NCBI, Web of Science, and Scopus databases were performed between January 2000 and August 2022. The retrieved genetic mutations were processed and annotated. Protein–protein network analysis was conducted for each neoplasm. The results were viewed and discussed in terms of molecular oncogenesis of ASCs and MACs at different topographies. Molecular profile mapping was conducted by annotating all the retrieved genes for each neoplasm using genetic network analysis (Cystoscape software program). The genetic profile of each lesion was compared to that of high-grade MEC. To conclude, both genetic profiles do not tend to intersect specifically with high-grade MEC, except for the generic mutations commonly detected in all high-grade head and neck tumors. However, the availability of data on the molecular profile of each lesion limits the generalizability of the findings of this study.
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Sjöstedt S, Vieira FG, Karnov K, Agander TK, Willemoe GL, Rohrberg KS, Nielsen FC, von Buchwald C. Differences in gene expression despite identical histomorphology in sinonasal intestinal-type adenocarcinoma and metastases from colorectal adenocarcinoma. APMIS 2022; 130:551-559. [PMID: 35662259 DOI: 10.1111/apm.13252] [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: 04/22/2022] [Accepted: 05/31/2022] [Indexed: 11/27/2022]
Abstract
Sinonasal intestinal-type adenocarcinoma (sITAC) is histomorphologically indistinguishable from colorectal adenocarcinoma (CRC) leading to diagnostic challenges. Metastases from CRCs to the sinonasal tract have been reported. The aim of the study was to identify a biomarker making it possible to distinguish between sITAC and metastases of colorectal origin. Formalin-fixated paraffin-embedded (FFPE) tissue from 20 consecutive patients with sITAC treated at Rigshospitalet, Denmark from 2005 to 2017, 20 patients with CRC, and second patients with both sinonasal and colorectal carcinomas were included, and RNA-sequencing was performed on all samples. Moreover, a series of 26 samples from metastasizing CRC were included (in-house data). 3139 differentially expressed genes were identified, of these several were deemed as possible biomarkers, including CSDE1, for which immunohistochemical staining was performed. sITAC and CRC differ in genomic expression. CSDE1, previously found upregulated in CRC, was significantly differentially expressed. Using immunohistochemical staining, no sITACs displayed strong and diffuse staining for CSDE1, which represents a potential marker to use in distinguishing sITAC from a metastasis of colorectal origin. This knowledge could improve the diagnostic process and hopefully the outcome in patients with this rare tumor.
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Affiliation(s)
- Sannia Sjöstedt
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Kirstine Karnov
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Gro Linno Willemoe
- Department of Genomic Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Finn Cilius Nielsen
- Department of Pathology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christian von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Copenhagen, Denmark
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Lohia N, Sadashiva H, Singh S, Agarwal S, Gupta V, Prashar M, Trivedi G. A Very Rare Case of Metastases to the Nasal Cavity from Primary Rectal Adenocarcinoma. CLINICAL CANCER INVESTIGATION JOURNAL 2022. [DOI: 10.51847/gehiwxwo0s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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6
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Sjöstedt S, Schmidt AY, Vieira FG, Woller NC, Nielsen FC, von Buchwald C. Intestinal metaplasia is a precursor lesion for sinonasal intestinal-type adenocarcinoma: genomic investigation of a case proving this hypothesis. APMIS 2021; 130:53-56. [PMID: 34741541 DOI: 10.1111/apm.13187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 09/30/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Sannia Sjöstedt
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Copenhagen University Hospital/Rigshospitalet, Copenhagen Ø, Denmark
| | - Ane Yde Schmidt
- Department of Genomic Medicine, Copenhagen University Hospital/Rigshospitalet, Copenhagen Ø, Denmark
| | - Filipe Garrett Vieira
- Department of Genomic Medicine, Copenhagen University Hospital/Rigshospitalet, Copenhagen Ø, Denmark
| | - Nina Claire Woller
- Department of Pathology, Copenhagen University Hospital/Rigshospitalet, Copenhagen Ø, Denmark
| | - Finn Cilius Nielsen
- Department of Genomic Medicine, Copenhagen University Hospital/Rigshospitalet, Copenhagen Ø, Denmark
| | - Christian von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Copenhagen University Hospital/Rigshospitalet, Copenhagen Ø, Denmark
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Leivo I, Holmila R, Luce D, Steiniche T, Dictor M, Heikkilä P, Husgafvel-Pursiainen K, Wolff H. Occurrence of Sinonasal Intestinal-Type Adenocarcinoma and Non-Intestinal-Type Adenocarcinoma in Two Countries with Different Patterns of Wood Dust Exposure. Cancers (Basel) 2021; 13:5245. [PMID: 34680393 PMCID: PMC8533857 DOI: 10.3390/cancers13205245] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/09/2021] [Accepted: 10/14/2021] [Indexed: 02/03/2023] Open
Abstract
Sinonasal intestinal-type adenocarcinoma is strongly associated with hardwood dust exposure. Non-intestinal-type adenocarcinoma is a rarer and less well-known subtype considered not to be related with wood dust exposure. We determined the relative numbers of these two tumor types in 56 sinonasal adenocarcinoma patients in France and Finland, relating them with carefully assessed wood dust exposure histories. Diagnostic workup including immunohistochemistry for the intestinal markers CDX2 and CK20 indicated that the proportions of the two tumors differed significantly between France and Finland. In Finnish samples non-intestinal adenocarcinomas were more common than intestinal-type adenocarcinomas (12 non-intestinal vs. nine intestinal), while in the French samples the reverse was true (six non-intestinal vs. 29 intestinal). Such remarkably dissimilar occurrence of these tumors in France and Finland presumably reflects different pathogenetic circumstances in the two countries, and perhaps their different patterns of wood dust exposure. In France the main source of wood dust is from hardwoods. In Finland it is derived from softwoods. This is the first systematic comparison of the occurrence of intestinal-type adenocarcinoma and non-intestinal-type adenocarcinoma in two countries with different wood usage. It appears to be the first systematic study on differences in wood dust exposure between intestinal-type adenocarcinoma and non-intestinal-type adenocarcinoma.
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Affiliation(s)
- Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku, Kiinamyllynkatu 10 D 5035, 20520 Turku, Finland
- Turku University Central Hospital, 20521 Turku, Finland
| | - Reetta Holmila
- Institute of Occupational Health, PB 40, 00251 Helsinki, Finland; (R.H.); (P.H.); (K.H.-P.); (H.W.)
| | - Danièle Luce
- Inserm U 1085-Institut de Recherche en Santé, Environnement et Travail (IRSET), Faculté de Médecine, BP-145, Campus de Fouillole, 97154 Pointe-à-Pitre, Guadeloupe, France;
| | - Torben Steiniche
- Institute of Pathology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark;
| | - Michael Dictor
- Department of Pathology, Lund Hospital, Sölvegatan 25B, 221 85 Lund, Sweden;
| | - Pirjo Heikkilä
- Institute of Occupational Health, PB 40, 00251 Helsinki, Finland; (R.H.); (P.H.); (K.H.-P.); (H.W.)
| | | | - Henrik Wolff
- Institute of Occupational Health, PB 40, 00251 Helsinki, Finland; (R.H.); (P.H.); (K.H.-P.); (H.W.)
- Department of Pathology, University of Helsinki, PB 20, 00014 Helsinki, Finland
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8
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Malignant Sinonasal Tumors: Update on Histological and Clinical Management. ACTA ACUST UNITED AC 2021; 28:2420-2438. [PMID: 34287240 PMCID: PMC8293118 DOI: 10.3390/curroncol28040222] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 02/03/2023]
Abstract
Tumors of nasal cavity and paranasal sinuses (TuNSs) are rare and heterogeneous malignancies, presenting different histological features and clinical behavior. We reviewed the literature about etiology, biology, and clinical features of TuNSs to define pathologic features and possible treatment strategies. From a diagnostic point of view, it is mandatory to have high expertise and perform an immunohistochemical assessment to distinguish between different histotypes. Due to the extreme rarity of these neoplasms, there are no standard and evidence-based therapeutic strategies, lacking prospective and large clinical trials. In fact, most studies are retrospective analyses. Surgery represents the mainstay of treatment of TuNSs for small and localized tumors allowing complete tumor removal. Locally advanced lesions require more demolitive surgery that should be always followed by adjuvant radio- or chemo-radiotherapy. Recurrent/metastatic disease requires palliative chemo- and/or radiotherapy. Many studies emphasize the role of specific genes mutations in the development of TuNSs like mutations in the exons 4-9 of the TP53 gene, in the exon 9 of the PIK3CA gene and in the promoter of the TERT gene. In the near future, this genetic assessment will have new therapeutic implications. Future improvements in the understanding of the etiology, biology, and clinical features of TuNSs are warranted to improve their management.
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Alpuim Costa D, Monteiro A, André T, Esteves S, Sargento I, Ferreira M, Alexandre T, Clara A, Freire J, Moreira A. A Potential Link Between Prolonged Cork Exposure and Intestinal-Type Sinonasal Adenocarcinoma - Special Findings of a Retrospective Cohort Analysis. Front Oncol 2020; 10:565036. [PMID: 33072596 PMCID: PMC7531325 DOI: 10.3389/fonc.2020.565036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 08/24/2020] [Indexed: 12/04/2022] Open
Abstract
Introduction intestinal-type sinonasal adenocarcinoma (ITAC) is a rare epithelium tumor of the nasal cavities and paranasal sinuses. Exposure to wood and leather dusts is a strong etiological factor related to its development. Prolonged cork exposure has rarely been associated. Materials and Methods thirty-seven-year (1981–2018) retrospective cohort analysis of all consecutive patients with sinonasal cancer (SNC) followed at our institution. Medical records were reviewed to determine patient demographics, occupational/environmental exposure, location and extent of the tumor, stage, histopathology findings, treatment strategies, and oncologic outcomes. Survival analysis was done using Kaplan–Meier method. Results we evaluated 379 patients with SNC, including 39 (10.3%) ITAC. Patient median age was 73 years (range 49–87), 56% male and 69% with identified professional occupational exposure (54% for cork; 69.2% considering only those for which an agent has been identified). Seventy-two percent had locally advanced disease (stage III or IVA–B). The initial treatment was surgery in 77%, and 54% received adjuvant radiotherapy. The median time to progression, progression-free survival, and overall-survival was 2.36 years (95% CI 1.54–8.70), 1.96 years (95% CI 1.43–3.74), and 3.51 years (95% CI 2.33–10.02), respectively. Conclusion ITAC is an uncommon malignancy that grows silently, which contributes to delayed diagnosis, advanced stage and low survival rates. In our cohort, we observed a high prevalence of cork occupational exposure. This finding may lead to the implementation of protection measures and suggest a potential link to be further studied.
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Affiliation(s)
| | - Ana Monteiro
- Department of Medical Oncology, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisbon, Portugal
| | - Teresa André
- Department of Medical Oncology, Hospital Central do Funchal, Madeira, Portugal
| | - Susana Esteves
- Department of Clinical Trials, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisbon, Portugal
| | - Isabel Sargento
- Department of Medical Oncology, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisbon, Portugal
| | - Margarida Ferreira
- Department of Medical Oncology, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisbon, Portugal
| | - Teresa Alexandre
- Department of Medical Oncology, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisbon, Portugal
| | - Ana Clara
- Department of Medical Oncology, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisbon, Portugal
| | - João Freire
- Department of Medical Oncology, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisbon, Portugal
| | - António Moreira
- Department of Medical Oncology, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisbon, Portugal.,Department of Clinical Trials, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisbon, Portugal
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10
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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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11
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Martínez-Girón R, Mosquera-Martínez J, Martínez-Torre S. Leptomeningeal dissemination from an ethmoidal sinus adenocarcinoma in cerebrospinal fluid cytology. QJM 2015; 108:821-2. [PMID: 25614610 DOI: 10.1093/qjmed/hcv004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Indexed: 11/14/2022] Open
Affiliation(s)
- R Martínez-Girón
- From the CFGS Anatomic Pathology and Cytology, Institute of Piedras Blancas, 33450 Asturias, Spain,
| | - J Mosquera-Martínez
- Medical Oncology Departament, Complejo Hospitalario Universitario de A Coruña, As Xubias, 84, 15006, A Coruña, Spain and
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Projetti F, Serrano E, Vergez S, Bissainthe AC, Delisle MB, Uro-Coste E. Is neuroendocrine differentiation useful to discriminate primary sinonasal intestinal-type adenocarcinomas from metastatic colorectal adenocarcinomas? J Clin Pathol 2014; 68:79-82. [PMID: 25294889 DOI: 10.1136/jclinpath-2014-202463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Primary sinonasal intestinal-type adenocarcinomas (ITAC) are defined on the basis of their morphological similarities to colorectal adenocarcinomas (CRA). Thus, differential diagnosis with sinonasal metastasis of CRA could be a real challenge. Neuroendocrine differentiation has been variably described in several types of adenocarcinomas and notably in ITACs and CRAs. In a series of 25 ITACs and 25 lymph node metastasis of CRAs (nmCRA), we analysed neuroendocrine differentiation by immunohistochemistry with anti-chromogranin A and synaptophysin antibodies. Neuroendocrine differentiation (chromogranin A and/or synaptophysin positivity) was significantly different (p=0.0002) in ITACs (72%) and in nmCRAs (20%). In conclusion, presence of neuroendocrine cells seems more in favour of a sinonasal intestinal-type adenocarcinoma, than metastatic CRA. This immunohistochemical study could be useful in difficult cases and should be an interesting complement in a clinical discussion.
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Affiliation(s)
- Fabrice Projetti
- Department of Pathology, Universitary Institute of Cancer, Toulouse, France Rangueil medical university, Toulouse, France
| | - Elie Serrano
- Rangueil medical university, Toulouse, France Department of Otorhinolaryngology-Head and Neck Surgery, Rangueil-Larrey University Hospital, Toulouse, France
| | - Sebastien Vergez
- Rangueil medical university, Toulouse, France Department of Otorhinolaryngology-Head and Neck Surgery, Universitary Institute of Cancer, Toulouse, France
| | - Anne-Charlotte Bissainthe
- Department of Pathology, Universitary Institute of Cancer, Toulouse, France Rangueil medical university, Toulouse, France
| | - Marie-Bernadette Delisle
- Department of Pathology, Universitary Institute of Cancer, Toulouse, France Department of Pathology, Rangueil University Hospital, Toulouse, France
| | - Emmanuelle Uro-Coste
- Department of Pathology, Universitary Institute of Cancer, Toulouse, France Rangueil medical university, Toulouse, France
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Antognoni P, Turri-Zanoni M, Gottardo S, Molteni M, Volpi L, Facco C, Freguia S, Mordacchini C, AlQahtani A, Bignami M, Capella C, Castelnuovo P. Endoscopic resection followed by adjuvant radiotherapy for sinonasal intestinal-type adenocarcinoma: Retrospective analysis of 30 consecutive patients. Head Neck 2014; 37:677-84. [DOI: 10.1002/hed.23660] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Revised: 11/25/2013] [Accepted: 03/01/2014] [Indexed: 11/10/2022] Open
Affiliation(s)
- Paolo Antognoni
- Department of Radiotherapy; Ospedale di Circolo e Fondazione Macchi; Varese Italy
| | - Mario Turri-Zanoni
- Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
| | - Stefania Gottardo
- Department of Radiotherapy; Ospedale di Circolo e Fondazione Macchi; Varese Italy
| | - Marinella Molteni
- Department of Radiotherapy; Ospedale di Circolo e Fondazione Macchi; Varese Italy
| | - Luca Volpi
- Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
| | - Carla Facco
- Department of Pathology, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
| | - Stefania Freguia
- Department of Pathology, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
| | - Cinzia Mordacchini
- Department of Medical Physics, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
| | - Abdulaziz AlQahtani
- Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
| | - Maurizio Bignami
- Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
| | - Carlo Capella
- Department of Pathology, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
| | - Paolo Castelnuovo
- Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
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14
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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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16
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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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17
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La Rosa S, Furlan D, Franzi F, Battaglia P, Frattini M, Zanellato E, Marando A, Sahnane N, Turri-Zanoni M, Castelnuovo P, Capella C. Mixed exocrine-neuroendocrine carcinoma of the nasal cavity: clinico-pathologic and molecular study of a case and review of the literature. Head Neck Pathol 2013; 7:76-84. [PMID: 22740238 PMCID: PMC3597157 DOI: 10.1007/s12105-012-0379-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 06/12/2012] [Indexed: 01/05/2023]
Abstract
Sinonasal intestinal-type adenocarcinomas (ITACs) are rare neoplasms histologically resembling intestinal adenocarcinomas. Although a neuroendocrine differentiation in ITACs has been described, true mixed exocrine-neuroendocrine carcinomas, neoplasms in which each component represents at least 30 % of the lesion, are extremely rare and their molecular alterations are largely unknown. We describe herein the clinico-pathologic features, the methylation profile, chromosomal gains and losses, and mutation analysis of KRAS, BRAF and p53 in a nasal mixed exocrine-neuroendocrine carcinoma resected in a 79-year-old man. The tumor was composed of an ITAC and a poorly differentiated neuroendocrine carcinoma. Both exocrine and neuroendocrine components were CK8, CK20, CDX2 and p53 positive, and CK7 and TTF1 negative. The neuroendocrine component also showed immunoreactivity for chromogranin A, synaptophysin, serotonin and glicentin. Gains and losses were found at following chromosome regions: 17p13 (TP53), 14q24 (MLH3), 19q13 (KLK3), 5q21 (APC), 7q21 (CDK6), 9q34 (DAPK1), 12p13 (TNFRSF 1A, CDKN1B), 13q12 (BRCA2), 17p13.3 (HIC1), 18q21 (BCL2), and 22q12 (TIMP3). Aberrant methylation was detected only in the neuroendocrine component and involved APC and DAPK1 genes. No mutation of KRAS (exons 2-4), BRAF (exon 15), and p53 (exons 4-10) was found in both components. The results suggest a monoclonal origin of the tumor from a pluripotent cell undergoing a biphenotypic differentiation and that the neuroendocrine differentiation may be from an exocrine to an endocrine pathway. We have also reviewed the literature on sinonasal mixed exocrine-neuroendocrine carcinomas to give to the reader a comprehensive overview of these very rare tumor types.
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Affiliation(s)
- Stefano La Rosa
- Department of Pathology, Ospedale di Circolo, viale Borri 57, 21100 Varese, Italy.
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Chondroid chordoma and nasal adenocarcinoma: an exceptional association. Case Rep Oncol Med 2012; 2012:861217. [PMID: 23024872 PMCID: PMC3457608 DOI: 10.1155/2012/861217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 08/26/2012] [Indexed: 11/17/2022] Open
Abstract
Collision tumors are exceptional, associating two independent tumoral contingents. We report a case of an association of two rare tumors: sinonasal adenocarcinoma and chondroid chordoma. Initially, only adenocarcinoma was diagnosed. The treatment consisted of endoscopic endonasal surgery followed by conventional radiotherapy. After 18 months, a local recurrence was diagnosed after a facial trauma, but the true histology was difficult to assess. The tumor was dual, associating adenocarcinoma and chondroid chordoma, with atypical localization in the ethmoid. Further evolution was particularly aggressive. We discuss the key points of this observation.
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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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Singh C, Jessurun J, Gulbahce HE, Pambuccian SE. Fine-needle aspiration diagnosis of metastatic intestinal-type sinonasal adenocarcinoma. Diagn Cytopathol 2011; 41:153-8. [PMID: 21710644 DOI: 10.1002/dc.21748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 05/05/2011] [Indexed: 11/07/2022]
Abstract
Fine-needle aspiration biopsy is a reliable and accurate method for the diagnosis of nodal metastases of head and neck cancers. We report the cytopathologic findings of a case of metastatic sinonasal intestinal type adenocarcinoma (ITAC) in a 58-year-old man who presented with enlarged cervical lymph nodes on a follow-up imaging study, 5 months after resection of a sinonasal ITAC. Ultrasound-guided fine needle aspiration of the station 2B lymph node yielded moderately cellular smears with abundant background mucin pools, numerous naked, atypical nuclei, and rare cells with signet ring cell morphology. Rare mitoses, apoptotic bodies, and necrotic debris were also present. Occasional clusters of signet ring cells were also seen in the cell block sections. Immunoperoxidase stains showed these cells to be positive for CK20 and villin. The differential diagnosis included a metastatic signet ring cell adenocarcinoma from the gastrointestinal tract and a metastatic sinonasal ITAC. Review of the previously resected sinonasal ITAC revealed a similar morphology with signet ring cells and abundant extracellular mucin production; the immunostaining results were also similar to those obtained on previously resected sinonasal ITAC. This case emphasizes the importance of considering primary head and neck tumors with intestinal phenotype and immunophenotype in the differential diagnoses of cervical lymph node metastases with signet ring cell morphology.
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Affiliation(s)
- Charanjeet Singh
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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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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Ninomiya F, Suzuki S, Tanaka H, Hayashi S, Ozaki K, Narama I. Nasal and paranasal adenocarcinomas with neuroendocrine differentiation in dogs. Vet Pathol 2008; 45:181-7. [PMID: 18424830 DOI: 10.1354/vp.45-2-181] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Tumors of the nasal cavity or paranasal sinuses of 18 dogs were examined histopathologically, immunohistochemically, and histochemically. The tumors were classified histologically as 13 adenocarcinomas, 3 transitional carcinomas, 1 squamous cell carcinoma, and 1 adenosquamous carcinoma. Tumor cells were strongly immunoreactive for broad-spectrum cytokeratins in all cases, for cytokeratin 8/18 in 16 cases, and for cytokeratin 19 in 17 cases. None of the 18 carcinomas had cytologic or histologic features indicative of neuroendocrine differentiation, yet tumor cells in 5 of the 13 adenocarcinomas were argyrophilic and immunohistochemically positive for synaptophysin and chromogranin A. Results of this study indicate that neuroendocrine markers may be detected immunohistochemically and histochemically in canine nasal or paranasal adenocarcinomas despite the lack of typical histologic features of neuroendocrine differentiation.
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Affiliation(s)
- F Ninomiya
- Drug Safety Research Lab, Taiho Pharmaceutical Co. Ltd., 224-2 Ebisuno, Hiraishi, Kawauchi-cho, Tokushima, Japan.
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Bansal A, Pradeep KE, Gumparthy KP. An unusual case of low-grade tubulopapillary adenocarcinoma of the sinonasal tract. World J Surg Oncol 2008; 6:54. [PMID: 18492272 PMCID: PMC2426684 DOI: 10.1186/1477-7819-6-54] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2007] [Accepted: 05/20/2008] [Indexed: 11/13/2022] Open
Abstract
Background Low-grade papillary adenocarcinomas of the sinonasal tract are rare neoplasms. Over recent years, little doubt remains that this tumour represents a separate entity based on morphology, ultrastructural features and behaviour. We outline a case of this rare entity displaying a not hitherto described immunophenotype. Case presentation A 32 year old man presented recurrent epistaxis was evaluated with endoscopy which revealed a well circumscribed pedunculated mass lesion in left nares. The mass was arising from the nasal septum which was excised along with the mass. The biopsy revealed low-grade, non-intestinal type sinonasal tubulopapillary adenocarcinoma. Conclusion TTF-1 immunoreactivity in absence of thyroid or pulmonary primary in the present case remains an enigma. However, this raises the possibility of the utility of this antibody to predict a better clinical outcome in the subset of low grade non-intestinal sinonasal adenocarcinoma. More cases of similar morphological appearance may need to be examined for TTF-1 immunoreactivity and clinically followed up to establish this theory.
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Affiliation(s)
- Ashish Bansal
- Department of Histopathology, Wirral Hospitals NHS Trust, Upton, Wirral, CH49 5PE, UK.
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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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Castillo C, Buob D, Mortuaire G, Chevalier D, Aubert S, Copin MC, Leroy X. Signet-Ring Cell Adenocarcinoma of Sinonasal Tract: An Immunohistochemical Study of the Mucins Profile. Arch Pathol Lab Med 2007; 131:961-4. [PMID: 17550327 DOI: 10.5858/2007-131-961-scaost] [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] [Accepted: 11/30/2006] [Indexed: 11/06/2022]
Abstract
Abstract
Context.—Adenocarcinomas of the sinonasal tract are classified into 4 categories: salivary-type, intestinal-type, nonintestinal-type, and metastatic. Signet-ring cell carcinoma is the rarest form of intestinal-type adenocarcinoma. Only isolated cases have been reported in the literature.
Objective.—To evaluate clinical attributes, morphology, and immunohistochemistry in signet-ring cell carcinoma of the sinonasal tract.
Design.—Seventy-three cases of primary sinonasal adenocarcinomas were retrieved from the files. Only 5 signet-ring cell adenocarcinomas (tumors composed of more than 90% signet-ring cells) were identified. In all cases, clinical data and histologic slides were available and were reviewed. Consecutive tissue sections were immunostained with monoclonal antibodies against MUC2, MUC5AC, MUC5B, MUC6, p53 protein, and MIB-1.
Results.—Four of our 5 patients were woodworkers. They were treated by surgical excision and radiotherapy. Patient follow-up ranged from 11 to 84 months. Three patients presented an unfavorable evolution and died of metastatic spread. Microscopically, the tumors produced abundant mucin deposits, which accumulated in large extracellular pools. Tumor cells were predominantly signet-ring cells floating in the pools of mucin. The mucins profile was MUC2+, MUC5AC+, MUC5B+, and MUC6−. Eighty percent of cells were immunostained by p53 protein antibody and 60% cells with MIB-1 antibody.
Conclusions.—The mucin profile is similar to the profile described in digestive tract adenocarcinoma. It is not useful to differentiate between metastatic adenocarcinoma and primary intestinal-type sinonasal adenocarcinoma. Clinical data and immunochemistry with p53 protein and MIB-1 confirm that sinonasal signet-ring cell carcinoma is a high-grade and aggressive tumor.
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Affiliation(s)
- Christine Castillo
- Department of Pathology, CHRU, Parc Eurasante, Nord, Lille, 59037, France
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