The results of our study suggest that pathologic differentiation may not be a critical factor in the. P16 and human papillomavirus in sinonasal squamous cell. Currently, it is believed that the best treatment for sinonasal undifferentiated carcinoma consists of multiple therapies, including surgery to remove as much of the tumor as possible, and chemotherapy andor radiation therapy to destroy any cancer cells. Outcomes of patients with sinonasal squamous cell carcinoma. Pdf on jan, 2014, md momenul haque and others published. Health, general cancer diagnosis carcinoembryonic antigen carcinoma cea oncology intermediate filament proteins neuroendocrine tumors care and treatment case studies risk factors nose cancer tissue specific antigens. The scan revealed significant destruction of the medial and lateral walls of the maxillary sinus as well as of the left orbital floor. She reported a history of left sided acinic cell carcinoma treated at an outside institution with endonasal resection and adjuvant radiotherapy approximately eight years prior.
Nov 10, 2016 sinonasal undifferentiated carcinoma snuc is a type of cancer that develops in the sinuses of the head. Sinonasal undifferentiated carcinoma genetic and rare. Unusual sinonasal smallcell neplasm following radiotherapy for bilateral carcinoma. The american joint committee on cancer ajcc tumornodemetastasis tnm classifications for cancers of the nasal cavity and paranasal sinuses are provided below, along with anatomic staging. Information about clinical trials is available from the nci website. Human papillomavirus related multiphenotypic sinonasal. Snuc is a clinicopathologically distinct carcinoma of uncertain histogenesis with no glandular or squamous features. Learn about sinus tumors from the cleveland clinic. The nasal cavity was the most common site for presentation, followed by the maxillary sinuses. Sinonasal undifferentiated carcinoma and nasopharyngealtype. Sinonasal undifferentiated carcinoma libre pathology. Health, general neuroendocrine tumors care and treatment diagnosis otorhinolaryngologic tumors. Jul 27, 2011 the impact of tumor differentiation on the behavior and response of sinonasal neuroendocrine carcinoma is unknown. Human papillomavirus hpvrelated multiphenotypic sinonasal carcinoma originally called hpvrelated carcinoma with adenoid cysticlike features is a recently recognized variant of sinonasal carcinoma showing histologic features of surface dysplasia and salivary gland carcinoma adenoid cystic carcinoma specifically and showing a strong association with hpv, especially hpv 33.
Data were analyzed for demographics, treatment type, stage, and histopathologic type. Sinonasal undifferentiated carcinoma snuc is a rare cancer of the nasal cavity andor paranasal sinuses. To date, there are only limited reports regarding this rare condition within the literature. Sarcomas comprise a diverse group of soft tissue mesenchymal malignancies. P16 and its relationship with hpv have not been defined in sinonasal malignancy nor has a link with outcomes been established. For most patients, there is no implicating factor although some studies have found that woodworkers and nickel factory workers are generally more susceptible to sinonasal malignancy of all types. Sinonasal cancer and occupational exposure in a population. Human papillomavirus hpv in oropharyngeal squamous cell carcinoma scc is a well. The latter are further divided into intestinaltype and nonintestinaltype adenocarcinomas. Clinical and imaging methods have been investigated as useful predictors of survival outcomes in sinonasal tract scc 24. Sinonasal undifferentiated carcinoma nord national.
Sinonasal undifferentiated carcinoma and nasopharyngeal. Metaanalysis of treatment outcomes for sinonasal undifferentiated carcinoma. Pathology outlines sinonasal undifferentiated carcinoma snuc. Sinonasal adenocarcinomas are primary tumors of the sinonasal region with glandular differentiation. Initial symptoms range from bloody nose, runny nose, double vision, and bulging eye to chronic infections and nasal obstruction. In most cases, symptoms present themselves at an advanced stage of disease. The treatment of salivarytype tumors is complete surgical removal. Jcm free fulltext imaging characteristics of malignant. However, generally in the literature and iarcwho classification, the term sinonasal adenocarcinoma refers to nonsalivary adenocarcinomas unless otherwise specified 1. This cancer is often confused with other poorly differentiated carcinomas that begin in the sinonasal tract. After adenoid cystic carcinoma, intestinaltype sinonasal adenocarcinoma is the second most common type of adenocarcinoma of the sinonasal tract.
The present study included 40 patients of sinonasal malignancy. Clinical presentation, demographics, treatment, and outcomes of this. Undifferentiated malignant neoplasms of the sinonasal tract. The objective of the current study was to evaluate prognostic factors, treatment outcomes, recurrence patterns, and survival rates for sinonasal adenoid cystic carcinoma. More recently, diseasefree actuarial survival and overall survival were. We examined occupational exposures among subjects with sinonasal cancer snc recorded in a populationbased registry in the lombardy region, the most populated and industrialized italian region.
Dec 28, 2018 sinonasal cancer is a rare aggressive cancer of the nasal cavity or the paranasal sinuses that mostly occurs in older individuals over 55 years. To more fully characterize the clinical and pathologic spectrum of a recently described tumor entity of the sinonasal tract characterized by loss of nuclear expression of smarcb1 ini1, we analyzed 39 smarcb1deficient sinonasal carcinomas collected from multiple medical centers. Radiation therapy for sinonasal undifferentiated carcinoma. Patient demographic data, clinical presentation, treatment. Get a printable copy pdf file of the complete article 1. Survival rates of sinonasal squamous cell carcinoma with. These carcinomas mimic the appearance intestinal adenomas and carcinomas, or exceptionally the normal glandular epithelium of the intestinal mucosa. Sinonasal undifferentiated carcinoma snuc is a rare aggressive neoplasm arising in the nasal cavity and paranasal sinuses. Treatment, outcomes, and demographics in sinonasal sarcoma. Sinonasal cancer snc has been related to occupational exposures, but the relative risk associated to specific jobs andor carcinogen exposures other than wood and leather dust is generally based on small or inadequate sample sizes and the range of observed estimates is large. Only 9 patients 30% were alive without disease at last followup range, 11 to 115 mo. Sinonasal undifferentiated carcinoma snuc is a rare and highly aggressive.
The sinonasal cavities are affected by a range of tumour types, the most common of which are sinonasal squamouscell carcinoma snscc and intestinaltype adenocarcinoma itac. Adenoid cystic carcinoma of the sinonasal tract is a rare cancer that accounts for 10% of all malignancies at this site. Sinonasal undifferentiated carcinoma snuc is a rare and highly aggressive neoplasm of the paranasal sinuses and nasal cavity which is characterized by rapid growth, a propensity for locoregional recurrence, distant metastases particularly to lung and bone, and poor prognosis. Sinonasal undifferentiated carcinoma snuc is an aggressive tumor that is two to three times more common in men and occurs over a broad age range average 55 to 60 years. Sinonasal undifferentiated carcinoma of the maxillary sinus. Although there are many histopathogical types of sinonasal cancers, for better comparison we focused exclusively on sinonasal squamous cell carcinoma. Malignancies of the nasal cavity and paranasal sinuses account for 1% of all malignancies and 3% of malignancies of the upper aerodigestive tract. Primary sinonasal clear cell carcinoma is an extremely rare neoplasm with epistaxis as one of the common early presentation and the diagnosis requires an exclusionary approach. Two of 7 patients 29% who received adjuvant chemotherapy developed hemafigure 1. Sinonasal undifferentiated carcinoma snuc is a rare and highly aggressive neoplasm of the paranasal sinuses, which has recently been characterized as a distinct pathologic entity. These malignancies are divided into salivarytype adenocarcinomas and nonsalivarytype adenocarcinomas. Some stages are split further, using capital letters a, b, etc. Sinonasal adenocarcinoma radiology reference article. Jun 17, 2014 the sinonasal cavities are affected by a range of tumour types, the most common of which are sinonasal squamouscell carcinoma snscc and intestinaltype adenocarcinoma itac.
Nov 14, 2019 1 human papillomavirus hpv related multiphenotypic sinonasal carcinoma hmsc, also known as hpvrelated carcinoma with adenoid cysticlike features, is a recently described neoplasm restricted to the sinonasal tract, with histological features of highgrade, solidtype acc, with hpv positivity and paradoxically indolent behavior. Primary sinonasal nasopharyngealtype undifferentiated carcinoma psnpc is an even rarer tumor that has not been adequately reported. Sinonasal undifferentiated carcinoma radiology case. Nov 10, 2016 treatment is determined for each affected individual based on the size of the tumor and whether it has spread to other parts of the body.
Cureus a case of sinonasal undifferentiated carcinoma with. Treatment is determined for each affected individual based on the size of the tumor and whether it has spread to other parts of the body. The impact of tumor differentiation on the behavior and response of sinonasal neuroendocrine carcinoma is unknown. Adenocarcinomas of the sinonasal tract may originate from respiratory surface epithelium or the underlying seromucinous glands. Survival rates of sinonasal squamous cell carcinoma with the. Clinical presentation, demographics, treatment, and outcomes of this uncommon disease are reported. Thirty patients with sinonasal malignancy were identified out of 570 head and neck cancer patients.
Local control, regional control, and locoregional control. In the sinonasal tract, nearly half of all malignancies arise in the nasal cavity, whereas most of the remaining malignancies arise in the maxillary or ethmoid sinus. Cureus a case of sinonasal undifferentiated carcinoma. The registry collects complete clinical information and exposure to carcinogens regarding all snc cases occurring in the population of the region. Original article, case study by ear, nose and throat journal. Pathology outlines sinonasal undifferentiated carcinoma.
It describes 3 new, welldefined entities and several lessdefined, emerging entities. The results of our study suggest that pathologic differentiation may not be a critical factor in the clinical. The most common type of sinonasal cancer is squamous cell carcinoma, in which cancer develops in the cells of the mucosa, the membrane that lines the nasal cavity and sinuses. The original diagnosis of retrospectively identified cases was most often sinonasal undifferentiated carcinoma n14 and nonkeratinizingbasaloid squamous cell carcinoma n5. Both tumors have been reported to be associated with epsteinbarr virus ebv. The tumors affected 23 males and 16 females with an age range of 19 to 89 years median, 52.
Sinonasal undifferentiated carcinoma snuc is a highly aggressive malignant neoplasm that is often difficult to distinguish from other poorly differentiated carcinomas arising in the sinonasal tract. Tkis, as evidenced by a response rate of greater than 80% and a median event free survival of nearly 24 months in patients with exon 11 mutant gist that were treated with imatinib 14. Mutant kit as imatinibsensitive target in metastatic. An 80 year old female presented to our otolaryngology clinic with an asymptomatic right sinonasal mass. Feb 28, 20 squamous cell carcinoma most common sinonasalmalignancy 70% arise in antrum 30% arise in nasal cavity 15% with synchronus ormetachronus lesion pre or coexisting papilloma isrisk factor 49% look for necrosis on imagingn. Squamous cell carcinoma scc in the sinonasal tract, which is accounted for about 3% of malignant tumors in the head and neck, is widely treated by intravenous or intraarterial chemoradiotherapy crt as nonsurgical definitive treatment. The earliest stage of nasal cavity and paranasal sinus cancers is stage 0, also known as carcinoma in situ cis. This retrospective study aimed to determine the clinical outcomes following particle monotherapy ie, proton therapy pt or carbon ion therapy cit in patients with sinonasal squamous cell carcinoma at a single institution. The patient was referred to the head and neck surgery department of a local hospital where contrastenhanced computed tomography was performed.
The aim of this study is to evaluate the relationship between the expression of p16 and infection of hpv16 in sinonasal squamous cell carcinoma and its clinical and pathological features. Sinonasal inverted papilloma ip is a locally aggressive tumor found in the schneiderian membrane, lining the nasal cavity and paranasal sinuses. The first symptoms of snuc may include difficulty breathing though the nose or mild facial pain. Sinonasal undifferentiated carcinoma snuc is a rare and highly aggressive malignancy, which accounts for approximately 35% of all sinonasal cancers. Sinonasal undifferentiated carcinoma originating from invert. Sinonasal cancer is a rare aggressive cancer of the nasal cavity or the paranasal sinuses that mostly occurs in older individuals over 55 years. The most common types include squamous cell carcinoma and adenocarcinoma. New types of treatment are being tested in clinical trials. Fifty per cent of patients had a squamous cell carcinoma and 27 per cent had a malignant melanoma. They are grossly classified as salivary and nonsalivary subtypes. Paranasal sinus and nasal cavity cancer is a type of head and neck cancer. We report a unique case of an 80yearold man who presented with a locally advanced snuc involving the ethmoid, sphenoid, and maxillary sinuses and bilateral lymph nodes, clinical t4n2m0. Paranasal sinus and nasal cavity cancer treatment adult. Sinonasal undifferentiated carcinoma snuc is a rare aggressive.
Sinonasal undifferentiated carcinoma snuc is an aggressive malignancy. Combinedmodality treatment improved outcome in sinonasal undifferentiated carcinoma. Squamous cell carcinoma most common sinonasalmalignancy 70% arise in antrum 30% arise in nasal cavity 15% with synchronus ormetachronus lesion pre or coexisting papilloma isrisk factor 49% look for necrosis on imagingn. On the other hand, differential diagnosis of a metastatic renal cell carcinoma should also include the rare sinonasal renal celllike adenocarcinoma of the sinonasal tract. Hpvrelated multiphenotypic sinonasal carcinoma lester d. Squamous cell carcinoma is the most common histological subtype of malignant. The 3year distant metastasis free survival rate was 82%. Given the continued discovery of entities generally specific to the sinonasal tract, the fourth edition of the world health organization classification of head and neck tumors was released in 2017. Sinonasal undifferentiated carcinoma snuc is a type of cancer that develops in the sinuses of the head. Hypercellular proliferation, with trabecular, solid, ribbon, lobular and organoid growth patterns composed of large, round to oval polygonal cells, with hyperchromatic to vesicular nuclei, inconspicuous to prominent nucleoli and a varying amount of eosinophilic cytoplasm and well defined to poorly defined cell borders. The sinuses and nasal region are a relatively rare site of sarcomas. Treatment for paranasal sinus and nasal cavity cancer may cause side effects. Sinonasal undifferentiated carcinoma snuc is a rare aggressive type of cancer that arises from epithelium or lining of the nose or sinuses. Snuc occurs when cells from the layer of tissue that lines the sinuses called the epithelium rapidly increase in number, forming a mass.
There are 6 who have survived free of disease at 14 years to 8 months followup. The most common type of sinonasal cancer is squamous cell carcinoma, in which cancer develops in the cells of the mucosa, the membrane that lines. The sinonasal tract is an environment diverse with neoplasia. Sinonasal undifferentiated carcinomasnuc free download as powerpoint presentation. Extranasal cancers that metastasize to the sinonasal cavity are very rare. Kaplanmeier analysis was used to assess and compare survival. Jcm free fulltext metastatic tumors of the sinonasal. Undifferentiated sinonasal malignant neoplasmswenig 699. Pdf presentation of sinonasal carcinoma researchgate. Distant metastasis free survival 5year 75% 3590% overall survival. Sinonasal undifferentiated carcinomasnuc carcinoma. Sinonasal undifferentiated carcinoma with intracranial extension. We tested the new ajcc staging system against the survival rates of patients with sinonasal cancers and investigated the characteristics of the patients whose stages were changed.
P16 and human papillomavirus in sinonasal squamous cell carcinoma. We report a unique case of an 80yearold man who presented with a locally advanced snuc involving the ethmoid, sphenoid, and maxillary. A diagnosis of sinonasal undifferentiated carcinoma snuc was reached. Sinonasal undifferentiated carcinoma pubmed central pmc. As a rule, the lower the number, the less the cancer has spread. A case of sinonasal undifferentiated carcinoma with brain. The 5year survival rates have ranged from 40 to 60 %, with the poorest results in adcc 3, 4. Head and neck clinic by ear, nose and throat journal. Sinonasal undifferentiated carcinoma snuc is an uncommon, highly aggressive, and clinicopathologically distinctive carcinoma of uncertain histogenesis. The tumor commonly arises primarily in the nasal cavity but also can originate from the sinuses.
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