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Mason RH, Chang K, Nassrallah G, Nijhawan N. Spindle Cell Carcinoma of the Ocular Adnexa: A Case Report and Literature Review. Ophthalmic Plast Reconstr Surg 2024:00002341-990000000-00452. [PMID: 39158474 DOI: 10.1097/iop.0000000000002744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2024]
Abstract
A 68-year-old woman was seen in oculoplastic consultation with a medial canthal lesion initially diagnosed as an atypical fibroxanthoma. On excisional biopsy, she was found to have a spindle cell carcinoma, which is a rare and reportedly more aggressive form of squamous cell carcinoma. We highlight the surgical technique of biopsy and reconstruction, the detailed histologic and immunohistochemical analysis required for accurate diagnosis, considerations for adjuvant treatment, and suggestions for systemic workup and surveillance. This case adds to the small body of available literature on primary spindle cell carcinoma of the ocular surface and ocular adnexa, which we have summarized. We hope that as more data becomes available, there will be clearer diagnostic and treatment algorithms for this uncommon presentation.
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Affiliation(s)
- Ryan H Mason
- Department of Ophthalmology, Mount Sinai Hospital
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Kenneth Chang
- Department of Ophthalmology, Mount Sinai Hospital
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Georges Nassrallah
- Department of Ophthalmology, Mount Sinai Hospital
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Navdeep Nijhawan
- Department of Ophthalmology, Mount Sinai Hospital
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
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Husain P, Husain B, Ahmed SK. Spindle Cell Carcinoma of Nasal Septum: A Rare Case Report with Review of Literature. Indian J Otolaryngol Head Neck Surg 2022; 74:1379-1381. [PMID: 36452657 PMCID: PMC9702316 DOI: 10.1007/s12070-021-02520-0] [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: 02/13/2021] [Accepted: 03/21/2021] [Indexed: 12/01/2022] Open
Abstract
Spindle Cell Carcinoma (SpCC) is a rare neoplasm that occurs mainly in the upper aero-digestive tract, mostly in larynx. We present a case of SpCC arising from nasal septum. Surgical excision was done with postoperative chemo-radiotherapy and the patient is in follow-up and is asymptomatic from the last 24 months.
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Affiliation(s)
- Parvez Husain
- Department of ENT, Expert ENT & Diagnostic Centre, 41, Indira Market, Uttar Pradesh, Barabanki, 225001 India
| | - Benazeer Husain
- Department of Oral Pathology, Expert ENT & Diagnostic Centre, Barabanki, India
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Bartram J, Scholfield DW, Adams A, Alusi G, Cottom H. Sinonasal carcinosarcoma with cartilaginous and rhabdomyoblastic components: A previously undescribed entity. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:e287-e298. [PMID: 35595621 DOI: 10.1016/j.oooo.2022.02.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/05/2022] [Accepted: 02/28/2022] [Indexed: 10/18/2022]
Abstract
Carcinosarcomas are rare, aggressive tumors seldom found in the sinonasal region. They classically consist of sarcomatous spindle cell and carcinomatous squamous cell elements. A 61-year-old woman presented reporting right-sided nasal discharge and obstruction. Examination demonstrated a large right-sided nasal mass, from which a biopsy was taken. Computed tomography and magnetic resonance imaging revealed a mass arising from the maxillary antrum and extending into the nasal cavity, ethmoid air cells, and frontal sinus. Right total maxillectomy with resection of the nasal tumour component was performed. Histological analysis demonstrated a high-grade malignancy with features consistent with carcinosarcoma with cartilaginous and rhabdomyoblastic elements, a histologic pattern that has not previously been described at this site. Magnetic resonance imaging 5 weeks postoperatively showed sizeable recurrence. Adjuvant chemotherapy and radiotherapy were commenced to excellent effect. Carcinosarcomas, though very rare at sinonasal sites, should be considered if biopsy demonstrates undifferentiated high-grade neoplasm with cytokeratin expression. These tumors require aggressive multimodal therapy for optimal outcomes.
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Affiliation(s)
- James Bartram
- Core Surgical Trainee, ENT Registrar, Department of Ear, Nose and Throat Surgery, Barts Health NHS Trust, London, UK.
| | - Daniel W Scholfield
- Core Surgical Trainee, ENT Registrar, Department of Ear, Nose and Throat Surgery, Barts Health NHS Trust, London, UK
| | - Ashok Adams
- Radiology Consultant, Department of Radiology, Barts Health NHS Trust, London, UK
| | - Ghassan Alusi
- Core Surgical Trainee, ENT Registrar, Department of Ear, Nose and Throat Surgery, Barts Health NHS Trust, London, UK; ENT Consultant, Institute of Cancer at Barts and the London, Queen Mary's School of Medicine and Dentistry, London, UK
| | - Hannah Cottom
- Consultant Pathologist, Department of Cellular Pathology, Barts Health NHS Trust, London, UK
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Kuo CC, Viola F, DeGiovanni JC, DeVictor S, Belles WJ. Carcinosarcoma of the Nasal Septum: A Case Report and Review of the Literature. Cureus 2021; 13:e18546. [PMID: 34754690 PMCID: PMC8570767 DOI: 10.7759/cureus.18546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2021] [Indexed: 11/06/2022] Open
Abstract
We report a case of a 62-year-old man with epistaxis and right-sided nasal obstruction. Nasal endoscopy revealed an exophytic mass arising from the anterior septum that extended posteriorly to the osteo-meatal complex. Excision with endoscopic sinus surgery was performed. Carcinosarcoma was diagnosed based on histopathology and immunohistochemical studies. The patient declined surgery and opted for chemoradiation therapy for the residual tumor. Six weeks after completion of the treatment, clinical resolution of the right nasal mass was noted. Carcinosarcomas are rare and rapidly growing tumors that have a high recurrence rate and are associated with poor patient prognosis. This report emphasizes the need for patients with prolonged nasal obstruction and epistaxis to consult otolaryngologists and undergo nasal endoscopy for definitive diagnosis and appropriate treatment.
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Affiliation(s)
- Cathleen C Kuo
- Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, USA
| | - Francesca Viola
- Otolaryngology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, USA
| | - Jason C DeGiovanni
- Otolaryngology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, USA
| | - Sam DeVictor
- Otolaryngology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, USA
| | - William J Belles
- Otolaryngology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, USA
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Molero Bermejo AI, García Sánchez L, Ibañez Lagunas I, Ortega de la Obra P, Blanco Gómez I, Ascensión Díaz A, Arranz González M. [Sarcomatoid carcinoma of the nasal cavity: a case report and review of the literature]. REVISTA ESPAÑOLA DE PATOLOGÍA : PUBLICACIÓN OFICIAL DE LA SOCIEDAD ESPAÑOLA DE ANATOMÍA PATOLÓGICA Y DE LA SOCIEDAD ESPAÑOLA DE CITOLOGÍA 2021; 54:59-64. [PMID: 33455695 DOI: 10.1016/j.patol.2019.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 01/16/2019] [Accepted: 01/19/2019] [Indexed: 10/27/2022]
Abstract
Spindle cell carcinoma of the nasal cavity is a rare variant of squamous cell carcinoma. We report a case of a 50 year-old male presenting with a polypoid mass in the left nasal cavity. Histologically, the tumor was biphasic, composed of non-keratinizing squamous nests and a sarcomatoid stroma with positivity for CKAE1-AE3. Metastatic ipsilateral lymph nodes were present and the patient underwent radical neck dissection, followed by adjuvant radiotherapy and cisplatin. Two years after diagnosis the patient is free of disease.
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Affiliation(s)
| | | | | | | | - Isabel Blanco Gómez
- Servicio de Anatomía Patológica, Hospital General de Segovia, Segovia, España
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de Souza Cruz EL, de Moraes ATL, de Souza Neves Filho F, Carneiro Junior JT, Cruz E Silva BT, Montalli VAM, de Melo Alves Júnior S, de Jesus Viana Pinheiro J. A rare case of invasive sinonasal carcinosarcoma. Int J Surg Case Rep 2020; 70:243-248. [PMID: 32422587 PMCID: PMC7231817 DOI: 10.1016/j.ijscr.2020.04.072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/29/2020] [Accepted: 04/19/2020] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION Carcinosarcomas are rare malignant neoplasms formed by embryonic tissues (ectoderm and mesoderm) and present remarkably aggressive character with unfavourable prognosis. These lesions are rarely diagnosed in the sinonasal cavity and only a few cases are reported in the literature. This manuscript aimed to report a rare case of a large and aggressive sinonasal carcinosarcoma that involved the facial middle third and to discuss the proposed treatment. PRESENTATION OF CASE A 54-year-old female patient sought treatment for a large swelling on the left side of the face. A CT-scan revealed an expansive hypodense image in the facial middle third. An incisional biopsy was performed under local anaesthesia and the material was sent for histopathological analysis. DISCUSSION Due to the extremely aggressive character of carcinosarcomas, the optimal management of carcinosarcomas remains uncertain and a challenge for clinicians. In this case report, the prognosis of such a large tumour became unfavourable since the patient sought late for treatment. Therefore, suspicion and early detection are crucial for improving the prognosis and quality of life of the patients with such neoplasia. CONCLUSION Besides being rare and extremely aggressive, sinonasal carcinosarcomas present worse patient survival when compared to other carcinosarcomas in the head and neck region. Thus, this report may contribute to a better understanding of this tumour behaviour.
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Alotaiby F, Islam MN, Bhattacharyya I, Cohen DM, Drew PA, Lai J. Carcinosarcoma Arising from Inverted Papilloma in a Patient with History of Radiotherapy for Sinonasal Squamous Cell Carcinoma. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e921827. [PMID: 32200390 PMCID: PMC7117858 DOI: 10.12659/ajcr.921827] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Patient: Male, 72-year-old Final Diagnosis: Sarcomatoid carcinoma arising from inverted papilloma Symptoms: Nasal mass • nasal obstruction Medication: — Clinical Procedure: Excsion Specialty: Pathology
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Affiliation(s)
- Faraj Alotaiby
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry Qassim University, Qassim, Saudi Arabia
| | - Mohammed N Islam
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Indraneel Bhattacharyya
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Donald M Cohen
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Peter A Drew
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA
| | - Jinping Lai
- Department of Pathology, Kaiser Permanente Sacramento Medical Center, Sacramento, CA, USA
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A Case of Invasive Sinonasal Carcinosarcoma: The Importance of Early Detection. Case Rep Otolaryngol 2018; 2018:2745973. [PMID: 29850334 PMCID: PMC5937599 DOI: 10.1155/2018/2745973] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 03/19/2018] [Indexed: 11/18/2022] Open
Abstract
Sinonasal carcinosarcomas represent rare neoplasms, with aggressive character and unfavourable prognosis. We present a case of extensive sinonasal carcinosarcoma extending into the anterior cranial fossa and into the orbit and also a review of the current international literature regarding this rare yet aggressive neoplasm. There is currently a lack of specific guidelines on the optimal management of sinonasal carcinosarcoma and the treatment represents a challenge for the clinician. The key message that we would like to disseminate to our colleagues is the importance of suspicion and early detection, as well as the necessity to adopt a holistic approach when counselling patients.
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Liu TW, Hung SH, Chen PY. Sinonasal spindle cell carcinoma presenting with bilateral visual loss: A case report and review of the literature. Oncol Lett 2016; 12:401-404. [PMID: 27347158 PMCID: PMC4906660 DOI: 10.3892/ol.2016.4620] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 03/18/2016] [Indexed: 11/05/2022] Open
Abstract
Spindle cell carcinoma (SpCC) is a rare variant of squamous cell carcinoma (SCC). SpCC of sinonasal origin is relatively rare and more aggressive than normal SCC. It most commonly involves the maxillary sinus, and rarely the sphenoid sinus. The present study reports a case of sphenoid sinus SpCC presenting with bilateral visual loss. Following endoscopic sinus decompression surgery, the patient was referred to the Oncology Department for a staging workup, and subsequently received concurrent chemoradiotherapy; however, the vision of the patient was not recovered, despite treatment. To the best of our knowledge, this is the first reported case of synchronous inverted papilloma of the sphenoid sinus and SpCC presenting with optic nerve compression.
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Affiliation(s)
- Tsung-Wei Liu
- Department of Otolaryngology - Head and Neck Surgery, Shuang Ho Hospital, Taipei Medical University, Taipei 110, Taiwan, R.O.C
| | - Shih-Han Hung
- Department of Otolaryngology, Taipei Medical University Hospital, Taipei 110, Taiwan, R.O.C.; Department of Otolaryngology, School of Medicine, Taipei Medical University, Taipei 110, Taiwan, R.O.C
| | - Po-Yueh Chen
- Department of Otolaryngology - Head and Neck Surgery, Shuang Ho Hospital, Taipei Medical University, Taipei 110, Taiwan, R.O.C.; Department of Otolaryngology, School of Medicine, Taipei Medical University, Taipei 110, Taiwan, R.O.C
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Kim SM, Kim MJ, Jung HA, Sun JM, Choi YL, Ko YH, Park K, Baek CH, Son YI, Ahn MJ. Presence of anaplastic lymphoma kinase translocation in sarcomatoid carcinoma of head and neck and treatment effect of crizotinib: A case series. Head Neck 2015; 37:E66-9. [DOI: 10.1002/hed.23884] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 09/27/2014] [Indexed: 11/09/2022] Open
Affiliation(s)
- Sung Min Kim
- Division of Hematology-Oncology; Department of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Seoul Korea
| | - Moon Jin Kim
- Division of Hematology-Oncology; Department of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Seoul Korea
| | - Hyun Ae Jung
- Division of Hematology-Oncology; Department of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Seoul Korea
| | - Jong-Mu Sun
- Division of Hematology-Oncology; Department of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Seoul Korea
| | - Yoon-La Choi
- Department of Pathology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - Young-Hyeh Ko
- Department of Pathology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - Keunchil Park
- Division of Hematology-Oncology; Department of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Seoul Korea
| | - Chung-Hwan Baek
- Department of Otorhinolaryngology-Head and Neck Surgery; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - Young-Ik Son
- Department of Otorhinolaryngology-Head and Neck Surgery; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - Myung-Ju Ahn
- Division of Hematology-Oncology; Department of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Seoul Korea
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