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Avey GD, Koszewski IJ, Agarwal M, Endelman LA, McDonald MA, Burr AR, Bruce JY, Penn L, Kennedy TA. Sinonasal Tumors: What the Multidisciplinary Cancer Care Board Wants to Know. Radiographics 2024; 44:e240035. [PMID: 39264836 DOI: 10.1148/rg.240035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2024]
Abstract
Sinonasal neoplasms are a remarkably heterogeneous group, reflecting the numerous tissue types present in the nasal cavity and paranasal sinuses. These entities can be relatively benign (ie, respiratory epithelial adenomatoid hamartoma) or can be exceedingly aggressive (ie, NUT carcinoma). Certain sinonasal tumors have a propensity to spread through local invasion and destruction, while others have a high likelihood of perineural spread. The genetic and molecular mechanisms underlying sinonasal tumor behavior have recently become better understood, and new tumor types have been described using these genetic and molecular data. This has prompted an expansion in the number of tumors included in the World Health Organization fifth edition classification system for head and neck tumors, along with a new classification structure. Radiologists' familiarity with this classification structure is crucial to understanding the expected behavior of these tumors and to collaboration with the multidisciplinary cancer care board in making decisions for optimal patient care. ©RSNA, 2024.
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Affiliation(s)
- Gregory D Avey
- From the Department of Radiology, Division of Neuroradiology (G.D.A., T.A.K.), Department of Otorhinolaryngology (I.J.K.), Department of Pathology, Division of Human Oncology (L.A.E.), Department of Human Oncology (A.R.B.), and Department of Medicine, Division of Human Oncology (J.Y.B.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; Department of Radiology, Medical College of Wisconsin, Milwaukee, Wis (M.A.); California Advanced Imaging Medical Associates, San Francisco, Calif (M.A.M.); and University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (L.P.)
| | - Ian J Koszewski
- From the Department of Radiology, Division of Neuroradiology (G.D.A., T.A.K.), Department of Otorhinolaryngology (I.J.K.), Department of Pathology, Division of Human Oncology (L.A.E.), Department of Human Oncology (A.R.B.), and Department of Medicine, Division of Human Oncology (J.Y.B.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; Department of Radiology, Medical College of Wisconsin, Milwaukee, Wis (M.A.); California Advanced Imaging Medical Associates, San Francisco, Calif (M.A.M.); and University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (L.P.)
| | - Mohit Agarwal
- From the Department of Radiology, Division of Neuroradiology (G.D.A., T.A.K.), Department of Otorhinolaryngology (I.J.K.), Department of Pathology, Division of Human Oncology (L.A.E.), Department of Human Oncology (A.R.B.), and Department of Medicine, Division of Human Oncology (J.Y.B.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; Department of Radiology, Medical College of Wisconsin, Milwaukee, Wis (M.A.); California Advanced Imaging Medical Associates, San Francisco, Calif (M.A.M.); and University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (L.P.)
| | - Levi A Endelman
- From the Department of Radiology, Division of Neuroradiology (G.D.A., T.A.K.), Department of Otorhinolaryngology (I.J.K.), Department of Pathology, Division of Human Oncology (L.A.E.), Department of Human Oncology (A.R.B.), and Department of Medicine, Division of Human Oncology (J.Y.B.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; Department of Radiology, Medical College of Wisconsin, Milwaukee, Wis (M.A.); California Advanced Imaging Medical Associates, San Francisco, Calif (M.A.M.); and University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (L.P.)
| | - Marin A McDonald
- From the Department of Radiology, Division of Neuroradiology (G.D.A., T.A.K.), Department of Otorhinolaryngology (I.J.K.), Department of Pathology, Division of Human Oncology (L.A.E.), Department of Human Oncology (A.R.B.), and Department of Medicine, Division of Human Oncology (J.Y.B.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; Department of Radiology, Medical College of Wisconsin, Milwaukee, Wis (M.A.); California Advanced Imaging Medical Associates, San Francisco, Calif (M.A.M.); and University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (L.P.)
| | - Adam R Burr
- From the Department of Radiology, Division of Neuroradiology (G.D.A., T.A.K.), Department of Otorhinolaryngology (I.J.K.), Department of Pathology, Division of Human Oncology (L.A.E.), Department of Human Oncology (A.R.B.), and Department of Medicine, Division of Human Oncology (J.Y.B.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; Department of Radiology, Medical College of Wisconsin, Milwaukee, Wis (M.A.); California Advanced Imaging Medical Associates, San Francisco, Calif (M.A.M.); and University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (L.P.)
| | - Justine Yang Bruce
- From the Department of Radiology, Division of Neuroradiology (G.D.A., T.A.K.), Department of Otorhinolaryngology (I.J.K.), Department of Pathology, Division of Human Oncology (L.A.E.), Department of Human Oncology (A.R.B.), and Department of Medicine, Division of Human Oncology (J.Y.B.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; Department of Radiology, Medical College of Wisconsin, Milwaukee, Wis (M.A.); California Advanced Imaging Medical Associates, San Francisco, Calif (M.A.M.); and University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (L.P.)
| | - Lauren Penn
- From the Department of Radiology, Division of Neuroradiology (G.D.A., T.A.K.), Department of Otorhinolaryngology (I.J.K.), Department of Pathology, Division of Human Oncology (L.A.E.), Department of Human Oncology (A.R.B.), and Department of Medicine, Division of Human Oncology (J.Y.B.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; Department of Radiology, Medical College of Wisconsin, Milwaukee, Wis (M.A.); California Advanced Imaging Medical Associates, San Francisco, Calif (M.A.M.); and University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (L.P.)
| | - Tabassum A Kennedy
- From the Department of Radiology, Division of Neuroradiology (G.D.A., T.A.K.), Department of Otorhinolaryngology (I.J.K.), Department of Pathology, Division of Human Oncology (L.A.E.), Department of Human Oncology (A.R.B.), and Department of Medicine, Division of Human Oncology (J.Y.B.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; Department of Radiology, Medical College of Wisconsin, Milwaukee, Wis (M.A.); California Advanced Imaging Medical Associates, San Francisco, Calif (M.A.M.); and University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (L.P.)
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Foust AM, Johnstone L, Krishnasarma R, Martin DC, Vaughn J, Shekdar K, Snyder E, Todd T, Pruthi S, Sarma A. Nontraumatic Pediatric Head and Neck Emergencies: Resource for On-Call Radiologists. Radiographics 2024; 44:e240027. [PMID: 39264838 DOI: 10.1148/rg.240027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2024]
Abstract
The vast array of acute nontraumatic diseases encountered in the head and neck of pediatric patients can be intimidating for radiologists in training in a fast-paced emergency setting. Although there is some overlap of pediatric and adult diseases, congenital lesions and developmental variants are much more common in the pediatric population. Furthermore, the relative incidences of numerous infections and neoplasms differ between pediatric and adult populations. Young patients and/or those with developmental delays may have clinical histories that are difficult to elicit or nonspecific presentations, underscoring the importance of imaging in facilitating accurate and timely diagnoses. It is essential that radiologists caring for children be well versed in pediatric nontraumatic head and neck emergency imaging. The authors provide an on-call resource for radiology trainees, organized by anatomic location and highlighting key points, pearls, pitfalls, and mimics of many acute nontraumatic diseases in the pediatric head and neck. ©RSNA, 2024 Supplemental material is available for this article.
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Affiliation(s)
- Alexandra M Foust
- From the Department of Radiology, Monroe Carell Jr Children's Hospital at Vanderbilt, 2200 Children's Way, Nashville, TN 37232 (A.M.F., L.J., R.K., D.C.M., E.S., T.T., S.P., A.S.); Department of Radiology, Phoenix Children's Hospital, Phoenix, AZ (J.V.); and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA (K.S.)
| | - Lindsey Johnstone
- From the Department of Radiology, Monroe Carell Jr Children's Hospital at Vanderbilt, 2200 Children's Way, Nashville, TN 37232 (A.M.F., L.J., R.K., D.C.M., E.S., T.T., S.P., A.S.); Department of Radiology, Phoenix Children's Hospital, Phoenix, AZ (J.V.); and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA (K.S.)
| | - Rekha Krishnasarma
- From the Department of Radiology, Monroe Carell Jr Children's Hospital at Vanderbilt, 2200 Children's Way, Nashville, TN 37232 (A.M.F., L.J., R.K., D.C.M., E.S., T.T., S.P., A.S.); Department of Radiology, Phoenix Children's Hospital, Phoenix, AZ (J.V.); and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA (K.S.)
| | - Dann C Martin
- From the Department of Radiology, Monroe Carell Jr Children's Hospital at Vanderbilt, 2200 Children's Way, Nashville, TN 37232 (A.M.F., L.J., R.K., D.C.M., E.S., T.T., S.P., A.S.); Department of Radiology, Phoenix Children's Hospital, Phoenix, AZ (J.V.); and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA (K.S.)
| | - Jennifer Vaughn
- From the Department of Radiology, Monroe Carell Jr Children's Hospital at Vanderbilt, 2200 Children's Way, Nashville, TN 37232 (A.M.F., L.J., R.K., D.C.M., E.S., T.T., S.P., A.S.); Department of Radiology, Phoenix Children's Hospital, Phoenix, AZ (J.V.); and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA (K.S.)
| | - Karuna Shekdar
- From the Department of Radiology, Monroe Carell Jr Children's Hospital at Vanderbilt, 2200 Children's Way, Nashville, TN 37232 (A.M.F., L.J., R.K., D.C.M., E.S., T.T., S.P., A.S.); Department of Radiology, Phoenix Children's Hospital, Phoenix, AZ (J.V.); and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA (K.S.)
| | - Elizabeth Snyder
- From the Department of Radiology, Monroe Carell Jr Children's Hospital at Vanderbilt, 2200 Children's Way, Nashville, TN 37232 (A.M.F., L.J., R.K., D.C.M., E.S., T.T., S.P., A.S.); Department of Radiology, Phoenix Children's Hospital, Phoenix, AZ (J.V.); and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA (K.S.)
| | - Ty Todd
- From the Department of Radiology, Monroe Carell Jr Children's Hospital at Vanderbilt, 2200 Children's Way, Nashville, TN 37232 (A.M.F., L.J., R.K., D.C.M., E.S., T.T., S.P., A.S.); Department of Radiology, Phoenix Children's Hospital, Phoenix, AZ (J.V.); and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA (K.S.)
| | - Sumit Pruthi
- From the Department of Radiology, Monroe Carell Jr Children's Hospital at Vanderbilt, 2200 Children's Way, Nashville, TN 37232 (A.M.F., L.J., R.K., D.C.M., E.S., T.T., S.P., A.S.); Department of Radiology, Phoenix Children's Hospital, Phoenix, AZ (J.V.); and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA (K.S.)
| | - Asha Sarma
- From the Department of Radiology, Monroe Carell Jr Children's Hospital at Vanderbilt, 2200 Children's Way, Nashville, TN 37232 (A.M.F., L.J., R.K., D.C.M., E.S., T.T., S.P., A.S.); Department of Radiology, Phoenix Children's Hospital, Phoenix, AZ (J.V.); and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA (K.S.)
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Valencia-Sanchez BA, Kim JD, Zhou S, Chen S, Levy ML, Roxbury C, Patel VA, Polster SP. Special Considerations in Pediatric Endoscopic Skull Base Surgery. J Clin Med 2024; 13:1924. [PMID: 38610689 PMCID: PMC11013018 DOI: 10.3390/jcm13071924] [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: 02/16/2024] [Revised: 03/20/2024] [Accepted: 03/23/2024] [Indexed: 04/14/2024] Open
Abstract
Originally pioneered in adults, endoscopic endonasal approaches for skull base pathology are being increasingly applied as a minimally invasive alternative for young children. Intrinsic anatomic differences between these patient populations have sparked discussions on the feasibility, safety, and efficacy of these techniques in pediatric patients. This work aims to serve as a primer for clinicians engaged in the rapidly evolving field of pediatric endoscopic skull base surgery. A succinct overview of relevant embryology, sinonasal anatomy, and diagnostic workup is presented to emphasize key differences and unique technical considerations. Additional discussions regarding select skull base lesions, reconstructive paradigms, potential surgical complications, and postoperative care are also highlighted in the setting of multidisciplinary teams.
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Affiliation(s)
| | - Jeeho D. Kim
- Department of Otolaryngology-Head and Neck Surgery, Naval Medical Center San Diego, San Diego, CA 92134, USA
| | - Sheng Zhou
- USC Caruso Department of Otolaryngology-Head and Neck Surgery, Los Angeles, CA 90033, USA
| | - Sonja Chen
- Department of Neurosurgery, University of Chicago, Chicago, IL 60637, USA (S.P.P.)
| | - Michael L. Levy
- Division of Pediatric Neurosurgery, Rady Children’s Hospital, San Diego, CA 92123, USA
- Department of Neurosurgery, University of California San Diego, La Jolla, CA 92093, USA
| | - Christopher Roxbury
- Department of Surgery, Section of Otolaryngology, University of Chicago Medicine, Chicago, IL 60637, USA;
| | - Vijay A. Patel
- Division of Pediatric Otolaryngology, Rady Children’s Hospital, San Diego, CA 92123, USA
- Department of Otolaryngology-Head and Neck Surgery, University of California San Diego, La Jolla, CA 92093, USA
| | - Sean P. Polster
- Department of Neurosurgery, University of Chicago, Chicago, IL 60637, USA (S.P.P.)
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Baba A, Matsushima S, Kessoku H, Omura K, Kurokawa R, Fukasawa N, Takeshita Y, Yamauchi H, Ogino N, Kayama R, Uchihara K, Yoshimatsu L, Ojiri H. Radiological features of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: case series and systematic review. Neuroradiology 2024; 66:249-259. [PMID: 38103083 DOI: 10.1007/s00234-023-03254-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE To comprehensively summarize the clinical data and CT/MRI characteristics of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA). METHODS Twenty-seven lesions from 25 study articles identified through a systematic review and three lesions from our institution associated with TL-LGNPPA were evaluated. RESULTS The mean age of the patients at diagnosis was 35.7 years, and the male-to-female ratio was nearly half. The chief complaint was nasal obstruction, followed by epistaxis. All patients underwent excision. None of the patients had neck nodes or distant metastases. All patients survived with no locoregional/distant recurrence during 3-93 months of follow-up. All lesions were located at the posterior edge of the nasal septum, attached to the nasopharyngeal parietal wall, and showed no laterality. The mean lesion diameter was 1.7 cm. The margins of lesions were well-defined and lobulated, followed by well-defined smooth margins. None of lesions were associated with parapharyngeal space or skull base destruction. All lesions were iso- and low-density on non-contrast CT. Adjacent skull base sclerosis was detected in 63.6% of lesions. High signal intensity on T2-weighted imaging and mostly iso-signal intensity on T1-weighted imaging compared to muscle tissue. Most lesions were heterogeneous and exhibited moderate contrast enhancement. Relatively large lesions (≥1.4 cm) tended to be more lobulated than smooth margins compared to relatively small lesions (<1.4 cm) (p = 0.016). CONCLUSION We summarized the clinical and radiological features of TL-LGNPPA to facilitate accurate diagnosis and appropriate management.
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Affiliation(s)
- Akira Baba
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Satoshi Matsushima
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hisashi Kessoku
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ryo Kurokawa
- Department of Radiology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Nei Fukasawa
- Department of Pathology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yuhei Takeshita
- Department of Radiology, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Hideomi Yamauchi
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Nobuhiro Ogino
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Reina Kayama
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kimiyuki Uchihara
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Lynn Yoshimatsu
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroya Ojiri
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
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