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Baptista Freitas M, Costa M, Freire Coelho A, Rodrigues Pereira P, Leal M, Sarmento C, Águas L, Barbosa M. Sinonasal Adenocarcinoma: Clinicopathological Characterization and Prognostic Factors. Cureus 2024; 16:e56067. [PMID: 38618397 PMCID: PMC11009698 DOI: 10.7759/cureus.56067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 04/16/2024] Open
Abstract
Sinonasal (SN) malignancies are rare. Within SN adenocarcinomas, the most frequent are intestinal-type adenocarcinomas (ITACs). ITAC has been associated with wood and leather dust occupational exposure and TP53 mutations. Not much information is available regarding its characterization and treatment. The aim of this study is to characterize the clinicopathologic and prognostic factors of patients with sinonasal adenocarcinomas (SNACs) treated in our tertiary-level hospital. A retrospective, consecutive study including SNAC patients diagnosed between 2004-2023 was conducted. Clinicopathological data was collected, and p53 status was assessed in the tumor specimens. The association between p53 status and clinicopathological variables, as well as their impact on survival, was evaluated. In total, 35 were included, most of them having ITAC (91.4%) with papillary subtype (37.5%); the majority were subjected to occupational risk exposure (82.9%). Overexpression of p53 was identified in 48.6% of the tumors. Papillary and colonic subtypes were associated with higher median progression-free survival (mPFS) than mucinous and solid subtypes (mPFS 37 months, 95% CI, 20.0-54.0, vs. 9 months, 95% CI, 7.15-10.85, p=0.01); the former was also associated with higher median overall survival (mOS) (mOS 64 months, 95% CI, 37.18-90.81 vs. 14 months, 95% CI, 0-41.58, p=0.02). Histologic grade 1-2 and macroscopic complete resection were associated with higher PFS (PFS of five months of 90.9% vs. 33.3%, p=0.01; mPFS of 37 months, 95% CI, 4.93-69.07 vs. 10 months, 95% CI, 6.43-13.57, p=0.04, respectively). Disease recurrence with distant metastases was associated with lower OS (11 months, 95% CI, 6.1-15.9 vs. 53 months, 95% CI, 22.70-83.30, p=0.04). This study reinforces the importance of protective occupational measures. Future studies will be important to validate the best treatment strategy in the advanced stages of this disease and also to identify new prognostic and/or therapeutic target biomarkers in SNAC.
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Affiliation(s)
| | - Mariana Costa
- Medical Oncology, Centro Hospitalar Universitário de São João, Porto, PRT
| | | | | | - Manuel Leal
- Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Cristina Sarmento
- Medical Oncology, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Lúcia Águas
- Medical Oncology, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Miguel Barbosa
- Medical Oncology, Centro Hospitalar Universitário de São João, Porto, PRT
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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: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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3
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Su YJ, Lee YH, Hsieh MS. SMARCB1(INI1)-deficient sinonasal adenocarcinoma: Report of a case previously diagnosed as high-grade non-intestinal-type sinonasal adenocarcinoma. Pathol Int 2021; 72:53-58. [PMID: 34597447 DOI: 10.1111/pin.13173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/16/2021] [Indexed: 12/01/2022]
Abstract
SMARCB1(INI1)-deficient sinonasal carcinoma is a recently recognized entity with wide histomorphologic spectrum. The classification of sinonasal adenocarcinoma (SNAC) is complex and yet to be redefined, especially the category of high-grade non-intestinal-type SNAC. Recently SMARCB1(INI1)-deficient SNACs with an unique oncocytoid/rhabdoid cytomorphology and variable degrees of glandular formation have been reported. Here we described a rare case of SMARCB1(INI1)-deficient SNAC composed of mainly oncocytoid/rhabdoid cells with mixed solid and cribriform patterns. This case was originally diagnosed as non-intestinal-type SNAC and was reclassified due to complete loss expression of SMARCB1(INI1) by immunohistochemistry (IHC). The SMARCB1(INI1) stain provides a valuable tool for identification of this specific type of SNAC. We compared this case with other SNACs diagnosed in our department and reviewed relevant literature for this specific type of SNAC.
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Affiliation(s)
- Yu-Ju Su
- Department of Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yi-Hsuan Lee
- Department of Pathology, National Taiwan University Hospital and National Taiwan, University College of Medicine, Taipei, Taiwan
| | - Min-Shu Hsieh
- Department of Pathology, National Taiwan University Hospital and National Taiwan, University College of Medicine, Taipei, Taiwan.,Graduate Institute of Pathology, College of Medicine, National Taiwan University, Taipei, Taiwan
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4
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Low CM, Balakrishnan K, Smith BM, Stokken JK, O'Brien EK, Van Gompel JJ, Rowan NR, Choby G. Sinonasal adenocarcinoma: Population-based analysis of demographic and socioeconomic disparities. Head Neck 2021; 43:2946-2953. [PMID: 34117674 DOI: 10.1002/hed.26783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/22/2021] [Accepted: 06/03/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Sinonasal adenocarcinoma (SNAC) is a rare tumor. The impact of health disparities on survival, stage at presentation, and utilization of surgery is not well understood in patients with SNAC. METHODS The Surveillance, Epidemiology, and End Results database was queried for cases of SNAC from 1973 to 2015. Cases were analyzed to assess for disparities in presentation, treatment, and survival. RESULTS SNAC was identified in 630 patients. In a multivariate model of overall survival, an age increase of 10 years (Hazard Ratio (HR) = 1.37, p < 0.001), male sex (HR = 1.26, p = 0.045), and more recent decade of diagnosis (HR = 0.74, p < 0.001) were significantly related to time-to-death. There is a higher rate of SNAC-related death in counties with more rural populations (p = 0.027). CONCLUSION Future interventions targeting rural and less well-educated populations may improve care with the goal of increasing the span of healthy life and reducing survival disparities related to SNAC.
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Affiliation(s)
- Christopher M Low
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Karthik Balakrishnan
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Byron M Smith
- Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - Janalee K Stokken
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Erin K O'Brien
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Jamie J Van Gompel
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.,Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Garret Choby
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.,Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Tachino H, Takakura H, Shojaku H, Fujisaka M, Akaogi K, Kawabe H, Naruto N, Shojaku H, Noguchi K, Miwa S, Imura J, Maeda Y. Case Report: Response to Intra-arterial Cisplatin and Concurrent Radiotherapy Followed by Salvage Surgery in a Patient With Advanced Primary Sinonasal Low-Grade Non-intestinal Adenocarcinoma. Front Surg 2020; 7:599392. [PMID: 33363200 PMCID: PMC7758204 DOI: 10.3389/fsurg.2020.599392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/03/2020] [Indexed: 11/17/2022] Open
Abstract
Background: The clinical usefulness of concurrent chemoradiotherapy before surgery in the treatment of primary, locally advanced sinonasal low-grade, non-intestinal type adenocarcinoma (LG non-ITAC) is unclear. Methods: We present the first case report of the efficacy of super-selective intra-arterial cisplatin (CDDP) infusion concurrent with conventional fractionated radiotherapy (RT) for LG non-ITAC in a Japanese patient. Results: A white, rugged-marginal mass that was histopathologically diagnosed as LG non-ITAC occupied the right nasal cavity. Based on the imaging findings, including computed tomography, magnetic resonance imaging, and positron emission tomography, the tumor was diagnosed as T4aN0M0, stage IVa. After treatment, the nasal tumor disappeared leaving only a small bulge in the medial wall of the middle turbinate. The patient also underwent right transnasal ethmoidectomy performed as salvage surgery. A histopathological examination revealed that the lesion was replaced by granulation tissue with lymphocytic infiltration and hemosiderin-laden macrophages, and no viable tumor cells remained. In the seven years after treatment, the patient has not experienced any local recurrence or regional or distant metastasis. Conclusions: Super-selective intra-arterial CDDP infusion concurrent with conventional fractionated RT followed by salvage surgery might be useful for the management of sinonasal LG non-ITAC.
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Affiliation(s)
- Hirohiko Tachino
- Department of Otolaryngology, University of Toyama, Toyama, Japan
| | | | - Hideo Shojaku
- Department of Otolaryngology, University of Toyama, Toyama, Japan
| | - Michiro Fujisaka
- Department of Otolaryngology, University of Toyama, Toyama, Japan
| | - Katsuichi Akaogi
- Department of Otolaryngology, Toyama Red Cross Hospital, Toyama, Japan
| | - Hideto Kawabe
- Department of Radiology, University of Toyama, Toyama, Japan
| | - Norihito Naruto
- Department of Radiology, University of Toyama, Toyama, Japan
| | - Hiroko Shojaku
- Department of Radiology, University of Toyama, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama, Toyama, Japan
| | - Shigeharu Miwa
- Department of Diagnostic Pathology, University of Toyama, Toyama, Japan
| | - Johji Imura
- Department of Diagnostic Pathology, University of Toyama, Toyama, Japan
| | - Yoshinobu Maeda
- Department of Pathological Diagnosis, Toyama Red Cross Hospital, Toyama, Japan
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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7
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Chweya CM, Low CM, Van Gompel JJ, Van Abel KM, Stokken JK, Choby G. Population-based analysis on the effect of nodal and distant metastases in sinonasal adenocarcinoma. Head Neck 2020; 43:128-136. [PMID: 32929799 DOI: 10.1002/hed.26457] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/19/2020] [Accepted: 08/26/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Minimal information has been reported on the effect of distant and nodal metastases at the time of diagnosis on survival in patients with sinonasal adenocarcinoma (SNAC). METHODS The Surveillance, Epidemiology, and End Results database was utilized to compare overall survival (OS) and disease-specific survival (DSS). RESULTS Of the 325 patients with SNAC identified, 5-year and 10-year OS for all included patients was 64% and 58%, respectively. On multivariate analysis, the presence of distant metastases (P < .0001), maxillary and frontal sinus primary tumors (P = .0042, P = .0006), and increasing age (P = .007) were risk factors for worsened DSS. The presence of regional spread to multiple cervical nodal basins (OS RR 3.26, P = .002; DSS RR 2.51, P = .013) and a single nodal basin (DSS RR 2.19, P = .046) was associated with worsened survival compared to no regional spread. CONCLUSION Survival in SNAC was significantly worsened with increasing age, tumor site of origin, and distant metastatic disease.
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Affiliation(s)
| | - Christopher M Low
- Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Jamie J Van Gompel
- Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Kathryn M Van Abel
- Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Janalee K Stokken
- Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Garret Choby
- Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
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8
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Patel NN, Maina IW, Kuan EC, Triantafillou V, Trope MA, Carey RM, Workman AD, Tong CC, Kohanski MA, Palmer JN, Adappa ND, Newman JG, Brant JA. Adenocarcinoma of the Sinonasal Tract: A Review of the National Cancer Database. J Neurol Surg B Skull Base 2019; 81:701-708. [PMID: 33381376 DOI: 10.1055/s-0039-1696707] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 07/28/2019] [Indexed: 12/13/2022] Open
Abstract
Background Sinonasal adenocarcinoma (SNAC) is a rare malignancy arising from mucus-secreting glandular tissue. Limited large-scale studies are available due to its rarity. We evaluated SNAC in the National Cancer Database (NCDB), a source that affords multi-institutional, population studies of rare cancers and their outcomes. Methods The NCDB was queried for adenocarcinoma in the sinonasal tract. Multivariate analyses were performed to evaluate for factors contributing to overall survival (OS). Results A total of 553 patients were identified. The cohort was composed of 59.3% males. The nasal cavity was the most common primary site, representing 44.1% of cases. About 5.7% of patients presented with nodal disease, while 3.3% had distant metastases. About 40.6% of cases presented with stage IV disease. About 73.5% of patients underwent surgery, 54.2% received radiation therapy, and 27.7% had chemotherapy. Median OS was 71.7 months, while OS at 1, 2, and 5 years was 82, 73.0, and 52%, respectively. On multivariate analysis, advanced age (hazard ratio [HR]: 1.04; 95% confidence interval [CI]: 1.02-1.05), Charlson-Deyo score of 1 (HR: 1.99; 95% CI: 1.20-3.30), advanced tumor grade (HR: 2.73; 95% CI: 1.39-5.34), and advanced tumor stage (HR: 2.71; 95% CI: 1.33-5.50) were associated with worse OS, whereas surgery (HR: 0.34; 95% CI: 0.20-0.60) and radiation therapy (HR: 0.55; 95% CI: 0.33-0.91), but not chemotherapy (HR: 1.16; 95% CI: 0.66-2.05), predicted improved OS. Conclusions SNAC is a rare malignancy with 5-year survival approximating 50%. Surgery and radiation therapy, but not chemotherapy, are associated with improved survival, and likely play a critical role in the interdisciplinary management of SNAC.
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Affiliation(s)
- Neil N Patel
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Ivy W Maina
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Edward C Kuan
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Vasiliki Triantafillou
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Michal A Trope
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Ryan M Carey
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Alan D Workman
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Charles C Tong
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Michael A Kohanski
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - James N Palmer
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Nithin D Adappa
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Jason G Newman
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Jason A Brant
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
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9
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Emanuelli E, Comiati V, Cazzador D, Schiavo G, Alexandre E, Fedeli U, Frasson G, Zanon A, Martini A, Scapellato ML, Mastrangelo G. Malignant Versus Benign Tumors of the Sinonasal Cavity: A Case-Control Study on Occupational Etiology. Int J Environ Res Public Health 2018; 15:E2887. [PMID: 30562946 PMCID: PMC6313789 DOI: 10.3390/ijerph15122887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 12/13/2018] [Accepted: 12/15/2018] [Indexed: 11/16/2022]
Abstract
Case-control studies on malignant sinonasal tumors and occupational risk factors are generally weakened by non-occupational confounders and the selection of suitable controls. This study aimed to confirm the association between sinonasal malignant tumors and patients' occupations with consideration for sinonasal inverted papillomas (SNIPs) as a control group. Thirty-two patients affected by adenocarcinoma (ADC) and 21 non-adenocarcinoma epithelial tumors (NAETs) were compared to 65 patients diagnosed with SNIPs. All patients were recruited in the same clinical setting between 2004 and 2016. A questionnaire was used to collect information on non-occupational factors (age, sex, smoking, allergies, and chronic sinusitis) and occupations (wood- and leather-related occupations, textile industry, metal working). Odds ratios (OR) with 95% confidence intervals (CI) associated with selected occupations were obtained by a multinomial and exact logistic regression. Between the three groups of patients, SNIP patients were significantly younger than ADC patients (p = 0.026). The risk of NAET increased in woodworkers (OR = 9.42; CI = 1.94⁻45.6) and metal workers (OR = 5.65; CI = 1.12⁻28.6). The risk of ADC increased in wood (OR = 86.3; CI = 15.2⁻488) and leather workers (OR = 119.4; CI = 11.3⁻1258). On the exact logistic regression, the OR associated to the textile industry was 9.32 (95%CI = 1.10⁻Inf) for ADC, and 7.21 (95%CI = 0.55⁻Inf) for NAET. Comparing sinonasal malignant tumors with controls recruited from the same clinical setting allowed demonstrating an increased risk associated with multiple occupations. Well-matched samples of cases and controls reduced the confounding bias and increased the strength of the association.
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Affiliation(s)
- Enzo Emanuelli
- Department of Neurosciences, Operative Unit of Otorhinolaryngology, University of Padova, Via Giustiniani 2, 35125 Padova, Italy.
| | - Vera Comiati
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Preventive Medicine and Risk Assessment Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Diego Cazzador
- Department of Neurosciences, Operative Unit of Otorhinolaryngology, University of Padova, Via Giustiniani 2, 35125 Padova, Italy.
| | - Gloria Schiavo
- Department of Neurosciences, Operative Unit of Otorhinolaryngology, University of Padova, Via Giustiniani 2, 35125 Padova, Italy.
| | - Enrico Alexandre
- Department of Neurosciences, Operative Unit of Otorhinolaryngology, University of Padova, Via Giustiniani 2, 35125 Padova, Italy.
| | - Ugo Fedeli
- Epidemiological Department, Veneto Region. Passaggio Gaudenzio 1, 35131 Padova, Italy.
| | - Giuliana Frasson
- Department of Neurosciences, Operative Unit of Otorhinolaryngology, University of Padova, Via Giustiniani 2, 35125 Padova, Italy.
| | - Alessia Zanon
- Department of Neurosciences, Operative Unit of Otorhinolaryngology, University of Padova, Via Giustiniani 2, 35125 Padova, Italy.
| | - Alessandro Martini
- Department of Neurosciences, Operative Unit of Otorhinolaryngology, University of Padova, Via Giustiniani 2, 35125 Padova, Italy.
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Preventive Medicine and Risk Assessment Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Giuseppe Mastrangelo
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Preventive Medicine and Risk Assessment Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
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10
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Martin J, Vayr F, Paris C, Vergez S, Krief P, Luc A, Corvisier J, de Gabory L, Herin F. Nasal fibroscopy as a routine screening procedure of sinonasal adenocarcinoma of woodworkers: French longitudinal case study. Head Neck 2018; 40:2193-2198. [PMID: 29756404 DOI: 10.1002/hed.25315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 10/30/2017] [Accepted: 04/03/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to assess the relevancy of flexible nasoendoscopy as a routine screening procedure of sinonasal adenocarcinoma among people occupationally exposed to wood dust. METHODS This study included woodworkers, occupationally exposed to wood dust. Evaluations were scheduled at the time of inclusion (T0) and after a 2-year period (T1). A questionnaire was used for standardized data collection. The score was based on anatomic landmarks on each side that are parts of the olfactory clefts: the area of middle turbinate, the anterior part of the olfactory cleft, the top of the choanal arch, the spheno-ethmoidal recess, the posterior part of the olfactory cleft, and the middle part of the olfactory cleft. RESULTS A total of 965 nasoendoscopies (T0+T1) were performed. Olfactory clefts were visualized in 72% of the cases. Nasoendoscopies revealed pathological findings in 33.6% of cases: polyps, thick nasal secretion aspect, mucous edema, retractile scars and synechia, crusts, mucous erythema, and growth. One case of carcinoma was confirmed. Adverse effects (epistaxis, blood mark on the endo-sheath, sneezing, or rhinorrhea) after the medical procedure occurred in 30% of cases without severe complications. CONCLUSION Flexible nasoendoscopy offers meaningful efficacy and a promising safety profile, and, therefore, could become the new cornerstone of the routine screening procedure of sinonasal adenocarcinoma among woodworkers.
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Affiliation(s)
- Julie Martin
- Occupational Disease Department, CHU de Toulouse, Toulouse, France.,Epidemiology, Health Economics and Public Health, UMR1027 INSERM, Toulouse, France
| | - Flora Vayr
- Occupational Disease Department, CHU de Toulouse, Toulouse, France
| | | | - Sébastien Vergez
- Otolaryngology Department, Head and Neck Surgery, CHU Toulouse, IUCT Oncopole, France.,University of Toulouse 3, CHU de Toulouse, Toulouse, France
| | - Peggy Krief
- Service of Occupational Medicine, Institute for Work and Health, University of Lausanne and Geneva, Epalinges-Lausanne, Switzerland
| | - Amandine Luc
- Research and Innovation Department, CHU de Nancy, Nancy, France
| | - Julie Corvisier
- Research and Innovation Department, CHU de Nancy, Nancy, France
| | | | - Ludovic de Gabory
- Otorhinolaryngology Department, University Hospital of Bordeaux, France
| | - Fabrice Herin
- Occupational Disease Department, CHU de Toulouse, Toulouse, France.,Epidemiology, Health Economics and Public Health, UMR1027 INSERM, Toulouse, France.,University of Toulouse 3, CHU de Toulouse, Toulouse, France
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11
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López-Hernández A, Pérez-Escuredo J, Vivanco B, García-Inclán C, Potes-Ares S, Cabal VN, Riobello C, Costales M, López F, Llorente JL, Hermsen MA. Genomic profiling of intestinal-type sinonasal adenocarcinoma reveals subgroups of patients with distinct clinical outcomes. Head Neck 2017; 40:259-273. [PMID: 28963820 DOI: 10.1002/hed.24941] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 07/19/2017] [Accepted: 07/28/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Patients with intestinal-type sinonasal adenocarcinoma (ITAC) have an unfavorable prognosis and new therapeutic approaches are needed to improve clinical management. METHODS Genetic analysis of 96 ITACs was performed by microarray comparative genomic hybridization and immunohistochemistry and correlated to previously obtained mutation, methylation, and protein expression data, and with pathological characteristics and clinical outcome. RESULTS Seven copy number alterations (CNAs) were significantly associated with unfavorable clinical outcome: gains at 1q22-23, 3q28-29, 6p22, and 13q31-33, and losses at 4p15-16, 4q32-35, and 10q24. Unsupervised cluster analysis resulted in 5 subgroups of ITAC with significantly distinct genetic signatures and clinical outcomes, independently of disease stage or histological subtype. CONCLUSION These data may guide studies to identify driver genes and signaling pathways involved in ITAC. In addition, the subclassification of genetic subgroups of patients with distinct clinical behavior can aid therapeutic decision making and may ultimately lead to personalized therapy with targeted inhibitors.
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Affiliation(s)
- Alejandro López-Hernández
- Department of Otolaryngology, IUOPA, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Jhudit Pérez-Escuredo
- Department of Otolaryngology, IUOPA, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Blanca Vivanco
- Department of Pathology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Cristina García-Inclán
- Department of Otolaryngology, IUOPA, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Sira Potes-Ares
- Department of Otolaryngology, IUOPA, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Virginia N Cabal
- Department of Otolaryngology, IUOPA, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Cristina Riobello
- Department of Otolaryngology, IUOPA, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - María Costales
- Department of Otolaryngology, IUOPA, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Fernando López
- Department of Otolaryngology, IUOPA, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - José Luis Llorente
- Department of Otolaryngology, IUOPA, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Mario A Hermsen
- Department of Otolaryngology, IUOPA, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
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12
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Felix-Ravelo M, Bey A, Arous F, Paris-Grandpierre S, Jankowski R, Nguyen DT. Relationship between 18FDG-PET and different types of sinonasal malignancies. Acta Otolaryngol 2017; 137:191-195. [PMID: 27576899 DOI: 10.1080/00016489.2016.1219917] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
CONCLUSION The sensitivity and specificity of a 18FDG-PET scan may be different according to the histology. The SUVmax and SUV ratio may reflect the tumor's aggressive behavior. OBJECTIVES To describe the characteristics of PET/CT scans, including the maximum standard uptake values (SUVmax), at initial diagnosis according to six main types of sinonasal malignancies: sinonasal adenocarcinoma (SNAC), sinonasal undifferentiated carcinoma (SNUC), adenoid cystic carcinoma (ACC), sinonasal malignant melanoma (SMM), olfactory neuroblastoma (ONB), and sinonasal neuroendocrine carcinoma (SNEC). METHODS A chart review of 50 patients who were diagnosed and treated for six sinonasal malignancy types over a period of 6 years was conducted. Any 18F-FDG PET/CT scans for each patient were searched using the hospital's intranet. The SUVmax of the primary sinonasal site was recorded. The liver SUVs were utilized as reference SUVs. The SUV ratio was defined as the ratio of the SUVmax of the primary tumor and the SUVliver. RESULTS The most common malignancy was SNAC (32%), followed by SNUC (24%), ONB (14%), ACC (10%), SMM (10%), and SNEC (10%). The SUVmax and SUV ratio values were significantly different between tumor types (p = 0.002 and 0.012, respectively). SNUC had the highest mean SUVmax (14.2), followed by SNAC (9.9). A similar mean SUVmax was observed for SMM, ONB, and ACC (∼ 7.0). SNEC up-takes the least 18FDG among these six tumor types (mean SUVmax = 4.7).
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Affiliation(s)
- Marylisa Felix-Ravelo
- Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Nancy, Nancy, France
| | - Ayoub Bey
- Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Nancy, Nancy, France
| | - Fabien Arous
- Faculty of Medicine, University of Lorraine, France
| | | | - Roger Jankowski
- Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Nancy, Nancy, France
- Faculty of Medicine, University of Lorraine, France
| | - Duc Trung Nguyen
- Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Nancy, Nancy, France
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13
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Hoeben A, van de Winkel L, Hoebers F, Kross K, Driessen C, Slootweg P, Tjan-Heijnen VCG, van Herpen C. Intestinal-type sinonasal adenocarcinomas: The road to molecular diagnosis and personalized treatment. Head Neck 2016; 38:1564-70. [PMID: 27224655 DOI: 10.1002/hed.24416] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 11/03/2015] [Accepted: 12/29/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Sinonasal intestinal-type adenocarcinomas (ITACs) are epithelial tumors of the nasal cavity and the paranasal sinuses, often related to professional exposure to organic dust, mainly wood or leather. It is a rare cancer. If resectable, surgery is the treatment of choice. Postoperative radiotherapy is often indicated to increase local control. Systemic treatment (chemotherapy, targeted agents, or immunotherapy) of irresectable ITACs and/or metastasized disease is less standardized. METHODS Articles on ITAC histopathology, molecular profile, and current treatment options of this specific tumor were identified and reviewed, using the electronic databases Pubmed, Medline, Cochrane, and Web of Science. RESULTS This article reviews what is currently known on the histopathology, tumorigenesis, molecular characteristics, and standardized treatment options of ITAC. CONCLUSION More translational research is needed to identify druggable targets that may lead to a personalized treatment plan in order to improve long-term outcome in patients with locally advanced and/or metastasized ITAC. © 2016 Wiley Periodicals, Inc. Head Neck 38: First-1570, 2016.
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Affiliation(s)
- Ann Hoeben
- Division of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Linda van de Winkel
- Division of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Frank Hoebers
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Kenneth Kross
- Department of Otolaryngology/Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Chantal Driessen
- Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Pieter Slootweg
- Department of Pathology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Vivianne C G Tjan-Heijnen
- Division of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Carla van Herpen
- Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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14
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Blumberg JM, Escobar-Stein J, Vining EM, Prasad ML. Low-Grade, Nonintestinal Nonsalivary Sinonasal Adenocarcinoma Associated With an Exophytic Schneiderian Papilloma: A Case Report. Int J Surg Pathol 2015; 23:662-6. [PMID: 26261100 DOI: 10.1177/1066896915599060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sinonasal adenocarcinoma is a rare tumor of the head and neck accounting for 10% to 20% of all primary malignancies of the nose and paranasal sinuses. There tumors are classified as salivary, intestinal and nonintestinal, nonsalivary. Low-grade nonintestinal nonsalivary are rare tumors whose diagnosis is essentially that of exclusion. Here we present the first case of one such tumor associated with an exophyic Schneiderian papilloma. A 71-year-old retired aerospace engineer presented with a 1-year history of severe nasal obstruction. Endoscopy and compted tomography imaging demonstrated a polypoid lesion occupying his entire right nasal cavity extending into and filling the nasopharynx. Biopsy suggested adenocarcinoma, at least in situ and the patient subsequently underwent complete resection. Pathologic evaluation demonstrated polypoid tumor consistent with a low-grade papillary adenocarcinoma with micropapillary architecture associated with a small amount of residual exophytic Schneiderian papilloma. Immunohistochemistry revealed diffuse expression of CK7, CK 5/6, and S100 protein in tumor cells. Expression of p63 was seen in basal cells only. Tumor cells did not show expression of CK20, CDX2 (intestinal markers), mammaglobin, GATA3 (salivary markers), PAX8, WT1, nor estrogen, progesterone, or androgen receptors confirming its nonintestinal nonsalivary differentiation.
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15
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Tilson MP, Gallia GL, Bishop JA. Among sinonasal tumors, CDX-2 immunoexpression is not restricted to intestinal-type adenocarcinomas. Head Neck Pathol 2013; 8:59-65. [PMID: 23846317 PMCID: PMC3950377 DOI: 10.1007/s12105-013-0475-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 07/03/2013] [Indexed: 12/14/2022]
Abstract
Intestinal-type adenocarcinoma (ITAC) is a rare form of sinonasal cancer characterized by an association with exposure to industrial dusts, aggressive clinical behavior, and histologic/immunophenotypic similarity to tumors of the gastrointestinal tract. ITAC is sometimes very poorly differentiated and difficult to distinguish from other sinonasal neoplasms, particularly in a limited biopsy. CDX-2 and cytokeratin 20 are consistently immunoreactive in ITAC and as a result, these immunostains are often used to support the diagnosis. However, CDX-2 and cytokeratin 20 have not been tested on a broad range of sinonasal tumors, so their specificities remain unknown. Immunohistochemistry for CDX-2 and cytokeratin 20 was performed on 6 sinonasal ITACs as well as 176 non-intestinal-type sinonasal neoplasms. CDX-2 and cytokeratin 20 were positive in all 6 cases of ITAC. CDX-2 immunoexpression was also observed in 17 of 176 (10 %) non-intestinal-type tumors including 6 of 16 (38 %) sinonasal undifferentiated carcinomas, 8 of 81 (10 %) squamous cell carcinomas (including 5 of 39 non-keratinizing variants), 2 of 20 (10 %) salivary-type adenocarcinomas, and 1 of 2 (50 %) small cell carcinomas. In contrast, among non-intestinal types of sinonasal tumors, cytokeratin 20 was only focally observed in 1 of 176 non-intestinal tumors (a non-keratinizing squamous cell carcinoma). All cases of non-intestinal surface-derived adenocarcinoma and esthesioneuroblastoma were negative for both markers. Both CDX-2 and cytokeratin 20 are highly sensitive for the diagnosis of sinonasal ITAC, but cytokeratin 20 is more specific. CDX-2 staining may be observed in other high grade tumor types, especially sinonasal undifferentiated carcinoma and non-keratinizing squamous cell carcinoma. As a result, in the setting of a poorly differentiated sinonasal carcinoma the diagnosis of ITAC should not be based on CDX-2 immunoexpression alone. Clear-cut glandular differentiation and cytokeratin 20 immunoexpression are more reliable features.
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Affiliation(s)
- Matthew P. Tilson
- grid.21107.350000000121719311Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD USA
| | - Gary L. Gallia
- grid.21107.350000000121719311Department of Neurosurgery, Johns Hopkins Medical Institutions, Baltimore, MD USA ,grid.21107.350000000121719311Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD USA
| | - Justin A. Bishop
- grid.21107.350000000121719311Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD USA ,grid.21107.350000000121719311Johns Hopkins University School of Medicine, 401 N. Broadway, Weinberg 2249, Baltimore, MD 21231 USA
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16
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Bhagia P, Colanta AB, Abramson DH, Carlson DL, Kleinerman RA, Kraus D, Dunkel IJ. Sinonasal adenocarcinoma: a rare second malignancy in long term retinoblastoma survivors. Pediatr Blood Cancer 2011; 57:693-5. [PMID: 21548012 PMCID: PMC3867788 DOI: 10.1002/pbc.23161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2010] [Accepted: 03/23/2011] [Indexed: 11/08/2022]
Abstract
Retinoblastoma is the most common primary cancer of the eye in children. The incidence of second tumors in survivors of bilateral retinoblastoma and in survivors of unilateral retinoblastoma who presumably carry a germline RB1 mutation is documented. This article describes the previously unrecognized association of sinonasal adenocarcinoma as a second malignancy in retinoblastoma survivors. We present three cases who received radiation therapy as a part of their treatment and developed sinonasal adenocarcinoma as a second malignancy. Sinonasal adenocarcinoma should be considered as a second malignancy in retinoblastoma survivors who present with vague sinus symptoms.
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Affiliation(s)
- Pooja Bhagia
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA.
| | | | | | - Diane L Carlson
- Director of Breast and Head and Neck Pathology, Cleveland Clinic
| | | | - Dennis Kraus
- Department of Surgery, Memorial Sloan Kettering Cancer Center
| | - Ira J. Dunkel
- Department of Pediatrics , Memorial Sloan Kettering Cancer Center
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17
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Abstract
The sinonasal tract is a complex anatomic site with an exhaustive list of possible diagnoses. While most biopsies or resections encountered routinely consist of common diagnoses such as inflammatory polyps and papillomas, occasional cases are more difficult, and separating reactive or benign from malignancy can be challenging. One of the most poorly understood and daunting categories is low grade glandular or tubular proliferations, particularly on small biopsies. Possible diagnoses such as reactive lesions, respiratory epithelial adenomatoid hamartoma (REAH), seromucinous (glandular) hamartoma (SH) and low grade sinonasal adenocarcinomas (LGSNAC) must be entertained. REAH is composed of respiratory epithelial lined submucosal glands with variable connection to the surface and periglandular hyalinization. SH is a tubular proliferation reminiscent of normal serous glands which may be associated with REAH. LGSNAC is a diverse group of bland tubular and/or papillary tumors, which have a recurrence potential but an as yet uncertain potential for metastasis or mortality. The management for these lesions can be vastly different and conservative management is preferable, making this distinction more than academic. However, complicating this category are controversies surrounding their nature as reactive lesions versus neoplasms, the histologic and immunohistochemical overlap, and possible precursor relationships between some of them.
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Affiliation(s)
- Ilan Weinreb
- Department of Pathology, University Health Network, 200 Elizabeth Street, Toronto, ON M5G 2C4 Canada ,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
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