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Thong JF, Chatterjee D, Hwang SY. Endoscopic Modified Lothrop Approach for the Excision of Bilateral Frontal Sinus Tumors. EAR, NOSE & THROAT JOURNAL 2019. [DOI: 10.1177/014556131409300310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Jiun Fong Thong
- Department of Otorhinolaryngology, Singapore General
Hospital, Singapore
| | | | - Siew Yoong Hwang
- Care Sinus Snoring ENT Centre, Gleneagles Medical
Centre, Singapore
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2
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Park ES, Kim J, Jun SY. Characteristics and prognosis of glomangiopericytomas: A systematic review. Head Neck 2017; 39:1897-1909. [DOI: 10.1002/hed.24818] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 11/07/2016] [Accepted: 04/07/2017] [Indexed: 12/12/2022] Open
Affiliation(s)
- Eun Su Park
- Department of Pathology; Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea; Incheon Republic of Korea
| | - Jiyoung Kim
- Department of Pathology; Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea; Incheon Republic of Korea
| | - Sun-Young Jun
- Department of Pathology; Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea; Incheon Republic of Korea
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Dahodwala MQ, Husain Q, Kanumuri VV, Choudhry OJ, Liu JK, Eloy JA. Management of sinonasal hemangiopericytomas: a systematic review. Int Forum Allergy Rhinol 2013; 3:581-7. [PMID: 23389865 DOI: 10.1002/alr.21139] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 08/17/2012] [Accepted: 11/17/2012] [Indexed: 12/14/2022]
Abstract
BACKGROUND Hemangiopericytomas are typically found in soft-tissue, but only rarely found in the sinonasal tract. Sinonasal hemangiopericytomas have been reported mostly through case studies, and optimal treatment is considered surgical excision. Classically, open surgical methods of tumor extirpation have been considered standard of care. With the wider use of endoscopic methods, an updated systematic review in terms of treatment is warranted. METHODS Cases were identified using a MEDLINE and PubMed search. Relevant studies were identified, and data was extracted regarding patient demographics, presenting symptoms, tumor characteristics, treatment, and outcomes. RESULTS A total of 128 cases were collected from 56 articles, consisting of case reports and series. The most common presenting symptoms were epistaxis, nasal obstruction, and facial pain/swelling/pressure. Computed tomography (CT) and X-ray were the most common modes of imaging during diagnosis and operative planning. The tumor often occupied multiple locations in the sinonasal tract at initial presentation. Surgical resection was the mainstay of treatment in 126 of the 128 cases (98.4%), either through open resection or endoscopic techniques. Surgical removal resulted in no recurrence in 79.7% of the cases. The use of endoscopic techniques increased significantly in the past decade. This review found no significant difference in terms of recurrence between endoscopic and open treatment groups, age, gender, and unilocality vs multilocality of tumor. CONCLUSION Surgical management remains the mainstay of treatment for hemangiopericytomas. Endoscopic resection of these lesions has increased over the last few decades and has become a safe, viable, and reasonable alternative to open resection.
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Affiliation(s)
- Mufaddal Q Dahodwala
- Department of Otolaryngology-Head and Neck Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ 07103, USA
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Duval M, Hwang E, Kilty SJ. Systematic review of treatment and prognosis of sinonasal hemangiopericytoma. Head Neck 2012; 35:1205-10. [PMID: 22733718 DOI: 10.1002/hed.23074] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2012] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND This study was undertaken to determine the recurrence rate for open and endoscopic surgery and the clinical prognosis of this sinonasal tumor. METHODS A systematic review of individual cases of sinonasal hemangiopericytoma was performed. A total of 97 articles were included in the study and reviewed to extract the relevant information about each case. RESULTS In all, 194 cases of sinonasal hemangiopericytoma were identified. There were 53 recurrences (27.3%), 6 tumor-related deaths (3.1%), and 4 cases of metastases (2.1%). There was no significant difference between rate of recurrence for endoscopic or open resection (p = .06). Incomplete excision was the most important predictor of recurrence (odds ratio = 11.50, 95% confidence interval 3.76-36.82, p < .001). Radiotherapy may be advantageous in cases of incomplete surgical resection (p = .03). CONCLUSIONS Complete excision is essential to minimize tumor recurrence and radiotherapy may decrease the rate of recurrence in the case of incomplete resection. Current evidence does not suggest that open resection is superior to endoscopic resection.
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Affiliation(s)
- Melanie Duval
- Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
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Rutkowski MJ, Sughrue ME, Kane AJ, Aranda D, Mills SA, Barani IJ, Parsa AT. Predictors of mortality following treatment of intracranial hemangiopericytoma. J Neurosurg 2010; 113:333-9. [PMID: 20367074 DOI: 10.3171/2010.3.jns091882] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Intracranial hemangiopericytoma (HPC) is a rare and malignant extraaxial tumor with a high proclivity toward recurrence and metastasis. Given this lesion's rarity, little information exists on prognostic factors influencing mortality rates following treatment with surgery or radiation or both. A systematic review of the published literature was performed to ascertain predictors of death following treatment for intracranial HPC. METHODS The authors identified 563 patients with intracranial HPC in the published literature, 277 of whom had information on the duration of follow-up. Statistical analysis of survival was performed using Kaplan-Meier and Cox regression analysis. RESULTS Hemangiopericytoma was diagnosed in 246 males and 204 females, ranging in age from 1 month to 80 years. Among patients treated for HPC, overall median survival was 13 years, with 1-, 5-, 10-, and 20-year survival rates of 95%, 82%, 60%, and 23%, respectively. Gross-total resection alone (105 patients) was associated with superior survival rates overall, with a median survival of 13 years, whereas subtotal resection alone (23 patients) resulted in a median survival of 9.75 years. Subtotal resection plus adjuvant radiotherapy led to a median survival of 6 years. Gross-total resection was associated with a superior survival benefit to patients regardless of the addition or absence of radiation, and patients receiving > 50 Gy of radiation had worse survival outcomes (median survival 4 vs 18.6 years, p < 0.01, log-rank test). Patients with tumors of the posterior fossa had a median survival of 10.75 versus 15.6 years for those with non-posterior fossa tumors (p < 0.05, log-rank test). CONCLUSIONS Treatment with gross-total resection provides the greatest survival advantage and should be pursued aggressively as an initial therapy. The addition of postoperative adjuvant radiation does not seem to confer a survival benefit.
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Affiliation(s)
- Martin J Rutkowski
- Brain Tumor Research Center, Department of Neurological Surgery, University of California, San Francisco, California, USA
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Kilde JD, Rhee JS, Balla AA, Smith MM, Smith TL. Hemangioma of the Sphenoid and Ethmoid Sinuses: Two Case Reports. EAR, NOSE & THROAT JOURNAL 2003. [DOI: 10.1177/014556130308200317] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Hemangiomas of the paranasal sinuses are rare, particularly those of the sphenoid and ethmoid sinuses. Although imaging of the sinuses is key to determining the extent of involvement, the diagnosis is based on the lesion's histologic appearance. Obtaining an adequate biopsy can be difficult in light of the risk of bleeding and the relative inaccessibility of lesions in this region. These obstacles can make the diagnosis and management of these lesions particularly challenging. We describe two new cases of sinonasal hemangioma—one in the ethmoid sinus and one in the ethmoid and sphenoid sinuses—and we discuss the diagnostic and therapeutic interventions that are needed to manage these lesions.
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Affiliation(s)
- John D. Kilde
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee
| | - John S. Rhee
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee
| | - Andre A. Balla
- Department of Pathology, Medical College of Wisconsin, Milwaukee
| | | | - Timothy L. Smith
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee
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Dufour H, Fesselet J, Métellus P, Figarella-Branger D, Grisoli F. Cavernous hemangioma of the sphenoid sinus: case report and review of the literature. SURGICAL NEUROLOGY 2001; 55:169-73; discussion 173. [PMID: 11311917 DOI: 10.1016/s0090-3019(00)00353-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Few cases of paranasal sinus cavernous hemangiomas have been reported in the literature. We report the first case of cavernous hemangioma of the sphenoid sinus and discuss therapeutic considerations and differential diagnosis. CASE DESCRIPTION A case of sphenoid sinus tumor in a 67-year-old woman is reported. The initial symptoms were a horizontal diplopia, a left facial dysesthesia, and a recent history of unusual headache. Physical examination revealed a left VIth nerve paresis. A CT scan was performed showing a hypodense homogeneous mass in the sphenoid sinus that was not enhanced after administration of contrast medium. MR study demonstrated on T1-weighted image an isointense nonenhancing homogeneous mass filling the sphenoid sinus. On T2-weighted images the tumor mass displayed a mild hyperintense signal. The patient was operated on via a transsphenoidal approach with total removal of the tumor. Pathological findings were consistent with a nonosseous cavernous hemangioma. MR imaging performed 5 years later was still normal. CONCLUSION The clinicoradiological and pathological features of this entity are described, and the literature reviewed.
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Affiliation(s)
- H Dufour
- Department of Neurosurgery, Timone Hospital, Marseille, France
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Reino AJ. Factors in the pathogenesis of tumors of the sphenoid and maxillary sinuses: a comparative study. Laryngoscope 2000; 110:1-38. [PMID: 11037807 DOI: 10.1097/00005537-200010001-00001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES/HYPOTHESIS To explain the processes that lead to the development of tumors in the maxillary and sphenoid sinuses. STUDY DESIGN A 32-year review of the world's literature on neoplasms of these two sinuses and a randomized case-controlled study comparing the normal mucosal architecture of the maxillary to the sphenoid sinus. METHODS Analysis of a 32-year world literature review reporting series of cases of maxillary and sphenoid sinus tumors. Tumors were classified by histological type and separated into subgroups if an individual incidence rate was reported. Histomorphometry of normal maxillary and sphenoid sinus mucosa was performed in 14 randomly selected patients (10 sphenoid and 4 maxillary specimens). Specimens were fixed in 10% formalin, embedded in paraffin, and stained with periodic acid-Schiff (PAS) and hematoxylin. Histomorphometric analysis was performed with a Zeiss Axioscope light microscope (Carl Zeiss Inc., Thornwood, NY) mounted with a Hamamatsu (Hamamatsu Photonics, Tokyo, Japan) color-chilled 3 charge coupled device digital camera. The images were captured on a 17-inch Sony (Sony Corp., Tokyo, Japan) multiscan monitor and analyzed with a Samba 4000 Image Analysis Program (Samba Corp., Los Angeles, CA). Five random areas were selected from strips of epithelium removed from each sinus, and goblet and basal cell measurements were made at magnifications x 100 and x 400. RESULTS The literature review revealed that the number and variety of tumors in the maxillary sinus are much greater than those in the sphenoid. The incidence of metastatic lesions to each sinus is approximately equal. No recognized pattern of spread from any particular organ system could be determined. On histomorphometric study there were no statistically significant differences between the sinuses in the concentration of goblet cells, basal cells, or seromucinous glands. CONCLUSIONS Factors involved in the pathogenesis of tumors of the maxillary and sphenoid sinuses include differences in nasal physiology, embryology, morphology, and topography. There are no significant histological differences in the epithelium and submucous glands between the two sinuses to explain the dissimilar formation of neoplasms.
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Affiliation(s)
- A J Reino
- Manhattan Ear, Nose and Throat Associates, New York, New York 10128, USA
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Marianowski R, Wassef M, Herman P, Huy PT. Nasal haemangiopericytoma: report of two cases with literature review. J Laryngol Otol 1999; 113:199-206. [PMID: 10435124 DOI: 10.1017/s0022215100143580] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Haemangiopericytoma (HPC) is a rare vascular tumour produced by proliferation of pericytes. One hundred and thirty-three cases of HPC have been reported in the nose and the paranasal sinuses. We present two more cases. Wide surgical excision via lateral rhinotomy, midfacial degloving, or endonasal removal is the treatment of choice. Radiotherapy has been used post-operatively in cases of incomplete removal. Life-long follow-up is required to evaluate local recurrence and late metastases.
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Affiliation(s)
- R Marianowski
- Service d'ORL et de Chirurgie Cervicofaciale, Hôpital Lariboisière, Paris, France
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Catalano PJ, Brandwein M, Shah DK, Urken ML, Lawson W, Biller HF. Sinonasal hemangiopericytomas: a clinicopathologic and immunohistochemical study of seven cases. Head Neck 1996; 18:42-53. [PMID: 8774921 DOI: 10.1002/(sici)1097-0347(199601/02)18:1<42::aid-hed6>3.0.co;2-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Sinonasal hemangiopericytoma (SNHPC) is a rare lesion usually of low-grade malignant potential. Aggressive and metastatic cases are uncommon, and experience using adjuvant therapy on these cases has been limited. Tumor-induced osteomalacia has a very rare association with SNHPC. Further, the diagnosis of SNHPC remains one of histologic-pattern recognition. Traditionally, immunohistochemistry has aided in excluding other diagnoses; only vimentin has been consistently expressed by the tumor spindle cells of HPC. Recent studies have shown that Factor XIIIa is also expressed by HPC, (as well as tumors of fibrohistiocytic differentiation) and hence may be yet another helpful positive marker in establishing an immunohistochemical profile. METHODS We identified 7 patients at this institution with SNHPC from 1990 to 1994. Immunohistochemistry was performed on seven formalin-fixed paraffin-embedded tumors utilizing antibodies to factor XIIIa as well as antibodies to vimentin, factor VIII, muscle-specific antigen, cytokeratin, and S-100. RESULTS All 7 patients were initially seen with nasal obstruction or epistaxis and underwent surgical resection. The period of follow-up was from 3 months to 14 years (mean 54 months) for 7 patients. Three patients had recurrent disease after 3, 5, and 10 years. The first 2 were known to have been originally treated by polypectomy. One patient required adjuvant radiotherapy for metastatic disease and local extension. One patient was initially seen with tumor-induced osteomalacia which dramatically improved following resection of the lesion. The immunohistochemical profile revealed strong expression of vimentin in 7/7 cases, and of factor XIIIa in 4/7 cases; tumor cells did not express the other markers studied. CONCLUSIONS Adequate surgical resection with negative margins appears to be the appropriate therapy for SNHPC. Our 1 case associated with tumor-induced osteomalacia was reversible after surgical excision of the tumor. The immunohistochemical results suggest that the pattern of vimentin and factor XIIIa positivity, as well as lack of expression of other markers, is consistent with the diagnosis of HPC, which still remains in the domain of histopathology.
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Affiliation(s)
- P J Catalano
- Department of Otolaryngology, Mount Sinai Medical Center, New York, NY 10029, USA
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 21-1992. A 65-year-old man with a mass that involved the base of the skull. N Engl J Med 1992; 326:1417-24. [PMID: 1569976 DOI: 10.1056/nejm199205213262108] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Abstract
The uncertain course and rarity of haemangiopericytoma in the nose and paranasal sinuses has interested both pathologists and clinicians. This tumour arises from proliferation of pericytes which invest capillary endothelium. A benign course is more common in the nose and paranasal sinuses. The first nasal haemangiopericytoma was reported by Stout in 1949. Since then only twenty cases have been reported in the literature. We present three further cases.
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Abstract
J.H. Maxwell, M.D., in 1959 presented a paper on, "The Diagnosis of Chronic Inflammatory Lesions of the Sphenoid Sinus." In that paper he reviewed chronic inflammatory lesions of the sphenoid sinus and demonstrated through means of case presentations various techniques required for proper diagnosis. During the past five years at the Geisinger Medical Center some interesting noninflammatory lesions of the sphenoid sinuses have been observed and will be reviewed. The symptoms of these sphenoid sinus lesions are usually related to abnormalities of the orbit and/or nasal passages. Cerebrospinal fluid rhinorrhea and meningitis may be present. Pain, when present, is generally not as severe as that described in inflammatory lesions, but is still localized in a similar manner. The diagnosis of sphenoid sinus disease may be suspected on the history and x-rays of the paranasal sinuses. Poytomography and computerized tomography scanning have aided markedly in the identification of the sphenoid lesions. Surgery in these cases included either a transnasal or sublabial transseptal approach to the sphenoid sinus and is recommended as a method to gain access to this rather obscure area.
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