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1.
Hum Pathol ; 89: 62-70, 2019 07.
Article in English | MEDLINE | ID: mdl-31054892

ABSTRACT

Sinonasal undifferentiated carcinoma (SNUC) is defined as undifferentiated carcinoma of the sinonasal tract without glandular or squamous features and not otherwise classifiable. SNUC is a rare tumor, with a long list of differential diagnoses, and often poses a considerable diagnostic challenge. In addition, recent advances in molecular and immunohistochemistry techniques have recognized several new entities that were previously included in the SNUC category. These include SMARCB1 (INI-1)-deficient carcinoma, NUT (nuclear protein in testis) carcinoma, adamantinoma-like Ewing sarcoma, and the most recently described and rarer SMARCA4 (BRG)-deficient carcinoma. In this study, we retrospectively reviewed 11 cases with an original diagnosis of SNUC. We found that a significant portion of those cases can be reclassified into specific entities, with potential impact on therapy and prognosis because of misclassification in 2 of these cases.


Subject(s)
Carcinoma/diagnosis , Carcinoma/pathology , Maxillary Sinus Neoplasms/diagnosis , Maxillary Sinus Neoplasms/pathology , Adult , Aged , Carcinoma/classification , Diagnosis, Differential , Female , Humans , Male , Maxillary Sinus Neoplasms/classification , Middle Aged , Paranasal Sinus Neoplasms/classification , Paranasal Sinus Neoplasms/diagnosis , Paranasal Sinus Neoplasms/pathology , Retrospective Studies , Young Adult
2.
Oral Oncol ; 90: 94-101, 2019 03.
Article in English | MEDLINE | ID: mdl-30846184

ABSTRACT

Epithelial sinonasal cancers (SNCs) are rare diseases with overlapping morphological features and a dismal prognosis. We aimed to investigate the expression differences among the histological subtypes for discerning their molecular characteristics. We selected 47 SNCs: (i) 21 nonkeratinizing squamous cell carcinomas (NKSCCs), (ii) 13 sinonasal neuroendocrine cancers (SNECs), and (iii) 13 sinonasal undifferentiated cancers (SNUCs). Gene expression profiling was performed by DASL (cDNA-mediated annealing, selection, extension, and ligation) microarray analysis with internal validation by quantitative RT-PCR (RT-qPCR). Relevant molecular patterns were uncovered by sparse partial-least squares discriminant analysis (sPLS-DA), microenvironment cell type (xCell), CIBERSORT, and gene set enrichment (GSEA) analyses. The first two sPLS-DA components stratified samples by histological subtypes. xCell highlighted increased expression of immune components (CD8+ effector memory cells, in SNUC) and "other cells": keratinocytes and neurons in NKSCC and SNEC, respectively. Pathway enrichment was observed in NKSCC (six gene sets, proliferation related), SNEC (one gene set, pancreatic ß-cells), and SNUC (twenty gene sets, some of them immune-system related). Major neuroendocrine involvement was observed in all the SNEC samples. Our high-throughput analysis revealed a good diagnostic ability to differentiate NKSCC, SNEC, and SNUC, but indicated that the neuroendocrine pathway, typical and pathognomonic of SNEC is also present at lower expression levels in the other two histological subtypes. The different and specific profiles may be exploited for elucidating their biology and could help to identify prognostic and therapeutic opportunities.


Subject(s)
Carcinoma, Neuroendocrine/genetics , Carcinoma, Squamous Cell/genetics , Carcinoma/genetics , Maxillary Sinus Neoplasms/genetics , Rare Diseases/genetics , Transcriptome , Adolescent , Adult , Aged , Aged, 80 and over , Biomarkers, Tumor/genetics , Carcinoma/classification , Carcinoma, Neuroendocrine/classification , Carcinoma, Squamous Cell/classification , Female , Gene Expression Profiling , Humans , Male , Maxillary Sinus Neoplasms/classification , Middle Aged , Prognosis , Rare Diseases/classification , Retrospective Studies , Tumor Microenvironment/genetics , Young Adult
3.
Arch Pathol Lab Med ; 143(11): 1416-1419, 2019 11.
Article in English | MEDLINE | ID: mdl-30779592

ABSTRACT

High-grade sinonasal carcinomas are a cohort of malignant epithelial neoplasms arising in the sinonasal cavities with distinct, ominous morphologic features or lacking well-differentiated features that might otherwise classify them as less biologically worrisome. Recent advances in molecular profiling have led to the identification of several distinct tumor entities previously grouped together. These molecularly distinct lesions include NUT (midline) carcinoma, INI1 (SMARCB1)-deficient carcinoma, SMARCA4-deficient sinonasal carcinoma, and novel IDH-mutant sinonasal undifferentiated carcinoma, in addition to the previously described lymphoepithelial carcinoma that may also be included in the differential diagnosis. The discovery of these distinct molecular tumor profiles may have significant clinical impact as targeted molecular-based therapeutics continue to evolve, and they may offer some respite for patients who have these highly aggressive cancers.


Subject(s)
Carcinoma/classification , DNA Helicases/genetics , Maxillary Sinus Neoplasms/classification , Nuclear Proteins/genetics , Oncogene Proteins/genetics , Paranasal Sinus Neoplasms/classification , SMARCB1 Protein/genetics , Transcription Factors/genetics , Carcinoma/genetics , Carcinoma/pathology , Cell Cycle Proteins/genetics , Gene Fusion , Humans , Maxillary Sinus Neoplasms/genetics , Maxillary Sinus Neoplasms/pathology , Mutation , Neoplasm Grading , Neoplasm Proteins , Paranasal Sinus Neoplasms/genetics , Paranasal Sinus Neoplasms/pathology , Paranasal Sinuses/pathology
4.
Am J Rhinol Allergy ; 27(4): 287-92, 2013.
Article in English | MEDLINE | ID: mdl-23883810

ABSTRACT

BACKGROUND: Sinonasal papillomas are benign epithelial neoplasms arising from Schneiderian mucosa. The three subtypes, exophytic, oncocytic, and inverted (inverted papilloma [IP]), should be distinguished from one another histopathologically. This study (1) highlights the histopathological and clinical differences between the Schneiderian papilloma subtypes and (2) identifies clinical features that potentially predict papilloma subtypes. METHODS: A retrospective review was performed of patients with Schneiderian papillomas over an 11-year period. RESULTS: Seventy patients with sinonasal papillomas who underwent sinus surgery were identified. There were 50 (71%) male and 20 (29%) female subjects diagnosed at an average age of 53 years (range, 13-80 years). Exophytic (n = 25), oncocytic (n = 9), and IP (n = 37) were identified. IP was associated with transformation into squamous cell carcinoma in three (8%) cases and dysplasia in three (8%) cases. Neither oncocytic nor exophytic subtypes were associated with dysplasia or malignancy. On multivariate analysis of potential predictors of papilloma subtype, history of chronic rhinosinusitis (CRS) and location of papilloma were significantly associated with papilloma subtype. Using classification and regression tree model, papilloma subtypes can be predicted based on presence or absence of CRS and papilloma location with nominal 82.4% accuracy. CONCLUSION: The inverted and exophytic type are the most common sinonasal papillomas, with the inverted type having an 8% rate of malignant transformation in this study. In contrast, the oncocytic type was not associated with dysplasia or malignancy in our series despite reports in the literature indicating malignant potential. History of CRS and papilloma location can provide clues to the histological subtype, which is important for surgical planning and patient counseling.


Subject(s)
Maxillary Sinus Neoplasms/pathology , Maxillary Sinus Neoplasms/surgery , Papilloma/pathology , Papilloma/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Cell Transformation, Neoplastic/pathology , Epithelial Cells/pathology , Female , Humans , Male , Maxillary Sinus Neoplasms/classification , Middle Aged , Nasal Mucosa/pathology , Nose Neoplasms/pathology , Nose Neoplasms/surgery , Papilloma/classification , Papilloma, Inverted/pathology , Papilloma, Inverted/surgery , Prognosis , Retrospective Studies , Risk Factors , Time Factors , Treatment Outcome
5.
Am J Surg Pathol ; 35(7): 971-80, 2011 Jul.
Article in English | MEDLINE | ID: mdl-21677536

ABSTRACT

Nonintestinal sinonasal adenocarcinomas (SNACs) are somewhat poorly characterized and high-grade nonintestinal SNACs have been only rarely reported. Here, we review our experience with these tumors. Twenty-seven cases of high-grade nonintestinal SNACs were identified from 22 men and 5 women. Ages ranged from 22 to 83 years (mean±1 standard deviation=54.7±18.6 y; median=60 y). Thirteen cases involved the nasal cavity and sinuses, 10 involved the nasal cavity only, and 4 involved sinuses only. Most cases had marked cytologic and nuclear pleomorphism, abundant mitotic activity, and necrosis; however, these features were not uniform. Although histologically heterogeneous, recurrent growth patterns were seen that resembled other neoplasms of the area. Tumors lacked CDX2 and CK20 immunoreactivity (aside from rare CK20 immunoreactive cells). High-grade nonintestinal SNACs are more common in men and, although they occur over a wide age range, they are much more common in older individuals. Histologically, they show a great deal of heterogeneity.


Subject(s)
Adenocarcinoma/pathology , Intestinal Neoplasms/pathology , Adenocarcinoma/classification , Adenocarcinoma/metabolism , Adult , Aged , Aged, 80 and over , Biomarkers, Tumor/metabolism , Carcinoma/classification , Carcinoma/metabolism , Carcinoma/pathology , Cell Nucleus/pathology , Female , Humans , Immunohistochemistry/methods , Intestinal Neoplasms/metabolism , Male , Maxillary Sinus Neoplasms/classification , Maxillary Sinus Neoplasms/metabolism , Maxillary Sinus Neoplasms/pathology , Middle Aged , Mitosis , Nasal Cavity/pathology , Necrosis , Paranasal Sinuses/pathology , Young Adult
6.
J Laryngol Otol ; 121(4): 404-7, 2007 Apr.
Article in English | MEDLINE | ID: mdl-17403266

ABSTRACT

We present a rare case of maxillary intraosseous vascular malformation and review the nomenclature used by pathologists and clinicians in classifying vascular anomalies. We also discuss the literature and highlight potential management pitfalls.


Subject(s)
Arteriovenous Malformations/diagnosis , Craniofacial Abnormalities/diagnosis , Hemangioma/diagnosis , Maxillary Sinus Neoplasms/diagnosis , Adult , Arteriovenous Malformations/classification , Eye Diseases/etiology , Hemangioma/classification , Humans , Magnetic Resonance Imaging , Male , Maxillary Sinus Neoplasms/classification , Terminology as Topic , Tomography, X-Ray Computed
7.
Otolaryngol Pol ; 59(5): 771-6, 2005.
Article in Polish | MEDLINE | ID: mdl-16471201

ABSTRACT

History of treatment of maxillary malignant neoplasms goes back to the middle of 19th century, when Gensoul and Lizzard performed their first maxillectomy. However the development of maxillar surgery is connected with achivements of Moure, who as the first one characterized and applied innovative skin cut on the face. Author presents the history of other surgical procedures in therapy of maxillary tumors and describes methods which are apply nowaday. Attention is paid to the Polish contributions and accomplishments in diagnostics and treatment of tumors localized in this area. The classification of maxillary tumors from Sebileau dissertation till the newest TNM classification from 2001 is described.


Subject(s)
Maxillary Sinus Neoplasms/history , Otorhinolaryngologic Surgical Procedures/history , Academic Medical Centers/history , Europe , History, 19th Century , History, 20th Century , Humans , Maxillary Sinus Neoplasms/classification , Maxillary Sinus Neoplasms/surgery , Poland
8.
Int J Oral Maxillofac Surg ; 33(4): 349-52, 2004 Jun.
Article in English | MEDLINE | ID: mdl-15145036

ABSTRACT

When the current T classification of the UICC (1987 and 1997) is used to stage carcinomas arising the upper alveolus and gingival and hard palate, most cases are classified as T4 because of their anatomic characteristics, similar to carcinomas arising in the lower alveolus and gingiva. This study compared the following two methods for classifying the T stage of maxillary carcinomas: (1) the original T classification criteria proposed by the UICC (1987 and 1997), and (2) a new T classification criteria, called the sinus and nasal floor (SNF) criteria. We found that the SNF criteria were more closely related to tumor control and survival than were the UICC criteria in patients with carcinomas arising in the upper alveolus and gingival and hard palate. Increased use of the SNF criteria is expected to improve staging of gingival tumors arising in the maxilla and increase the accuracy of diagnosis, especially of T4 tumors.


Subject(s)
Gingival Neoplasms/classification , Maxillary Neoplasms/classification , Neoplasm Staging/methods , Palatal Neoplasms/classification , Adenocarcinoma/classification , Adenocarcinoma/pathology , Adenoma, Pleomorphic/classification , Adenoma, Pleomorphic/pathology , Adult , Aged , Aged, 80 and over , Carcinoma, Adenoid Cystic/classification , Carcinoma, Adenoid Cystic/pathology , Carcinoma, Squamous Cell/classification , Carcinoma, Squamous Cell/pathology , Female , Gingival Neoplasms/pathology , Humans , Male , Maxillary Neoplasms/pathology , Maxillary Sinus Neoplasms/classification , Middle Aged , Neoplasm Invasiveness , Nose Neoplasms/classification , Palatal Neoplasms/pathology
9.
J Laryngol Otol ; 109(10): 1019-22, 1995 Oct.
Article in English | MEDLINE | ID: mdl-7499939

ABSTRACT

Ameloblastic carcinoma is an unusual tumour. There have been a total of 34 cases of ameloblastic carcinoma in the English literature to date. Of these only 11 cases have occurred in the maxilla. The authors report the 12th such case. The histological classification for odontogenic carcinoma has been debated for many years and recently revised, thus differentiating between malignant ameloblastoma and ameloblastic carcinoma. The authors review the current literature regarding diagnosis and treatment of this unusual lesion, and support the use of the term malignant ameloblastoma for the tumours that metastasize in spite of their benign histological appearance, whereas, the ameloblastic carcinoma is referred to as the primary tumour with malignant transformation, regardless of its metastatic potential.


Subject(s)
Maxillary Sinus Neoplasms/pathology , Odontogenic Tumors/pathology , Aged , Aged, 80 and over , Female , Humans , Maxillary Sinus Neoplasms/classification , Odontogenic Tumors/classification
10.
Laryngoscope ; 105(8 Pt 1): 847-53, 1995 Aug.
Article in English | MEDLINE | ID: mdl-7630298

ABSTRACT

This study comprised 17 cases of inverted papilloma, which were divided into two groups. The first group included 8 cases that lacked maxillary sinus involvement. They were subjected to intranasal endoscopic resection with safety margin. The second group included 9 cases involving the maxillary sinus with or without nasal extension. They were subjected to transnasal endoscopic medial maxillectomy. Follow-up for an average of 43 months in group 1 and 28 months in group 2 (excluding the 5 cases with less than 2 years of follow-up) showed no recurrence. The author realized that inverted papilloma can be divided into two groups from the anatomic and behavioral points of view and accordingly should be managed differently. For those lesions without involvement of the maxillary sinus, intranasal endoscopic resection is effective; for those lesions with maxillary sinus involvement, transnasal medial maxillectomy, which could be performed safely under endoscopic control, is recommended.


Subject(s)
Maxillary Sinus Neoplasms/surgery , Papilloma, Inverted/surgery , Adult , Aged , Endoscopy , Female , Humans , Male , Maxillary Sinus Neoplasms/classification , Maxillary Sinus Neoplasms/diagnostic imaging , Middle Aged , Papilloma, Inverted/classification , Papilloma, Inverted/diagnostic imaging , Tomography, X-Ray Computed , Treatment Outcome
12.
Nihon Gan Chiryo Gakkai Shi ; 24(6): 1277-87, 1989 Jun 20.
Article in English | MEDLINE | ID: mdl-2794652

ABSTRACT

Seventy-six cases with squamous cell carcinoma of the maxillary sinus were treated with radiotherapy and surgery with or without intra arterial infusion between 1969 to 1985 at the Tokyo Women's Medical College. T classification was made of all cases using the Japan Joint Committee (JJC, 1967), American Joint Committee (AJC, 1977) and Union Internationale Contre le Cancer (UICC, 1987) classifications. 1) By the JJC classification, there were 20 cases in T2, 44 in T3 and 12 in T4. By the AJC classification, there were 9 cases in T2, 58 in T3 and 9 in T4. The classification of 14 cases were changed from JJC T2 to AJC T3, because of extension to the medial nasal meatus. By the UICC classification, there were 27 T2 cases, 32 T3 and 17 T4. 2) Cervical lymph node metastasis was detected in 14 cases (18%) at initial diagnosis and most were found in T3 and T4 cases. 3) The cumulative 5-year survival rates were 67% for T2, 32% for T3 and 25% for T4 by the JJC classification and statistical differences (p less than 0.05) were seen in T2-T3 and T2-T4. In the AJC classification, these were 71% for T2, 37% for T3 and 22% for T4 and no statistical significance was found among them. By the UICC classification, the 5-year survival was 58% for T2, 26% for T3 and 38% for T4 and marked statistical significance (p less than 0.01) was seen in T2-T3 and T2-T4. 4) The cumulative 5-year survival rate in 14 patients with tumor extension to the medial nasal meatus was 55% and it is appropriate to define this stage as T2 in the new UICC classification. These data suggested that UICC classification (1987) is useful and correlated with prognostic analysis.


Subject(s)
Carcinoma, Squamous Cell/classification , Maxillary Sinus Neoplasms/classification , Paranasal Sinus Neoplasms/classification , Adult , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/therapy , Combined Modality Therapy , Female , Humans , Male , Maxillary Sinus Neoplasms/mortality , Maxillary Sinus Neoplasms/therapy , Middle Aged , Survival Rate
13.
J Laryngol Otol ; 102(3): 224-6, 1988 Mar.
Article in English | MEDLINE | ID: mdl-3356929

ABSTRACT

The site of origin of maxillary sinus carcinoma will not infrequently predetermine the varied neurological signs at presentation. Modifying Ohngren's division, the maxillary sinus can be divided into four quadrants based on anatomical nerve correlates, thus facilitating identification of the primary site. An inclusive classification of maxillary sinus carcinoma based on Broder's grading, site of origin, the TNM classification and the patient's general condition, serves as the basis for a correlative therapeutic regimen.


Subject(s)
Carcinoma/pathology , Maxillary Sinus Neoplasms/pathology , Paranasal Sinus Neoplasms/pathology , Carcinoma/classification , Humans , Maxillary Sinus/pathology , Maxillary Sinus Neoplasms/classification , Neoplasm Staging , Prognosis
14.
Arch Otolaryngol Head Neck Surg ; 113(4): 409-10, 1987 Apr.
Article in English | MEDLINE | ID: mdl-3814393

ABSTRACT

A system of classification that reflects the site of origin within the sinus cavity is proposed for maxillary sinus carcinoma. Careful examination for areas of anesthesia or pain over the distribution of the various branches of the infraorbital nerve may localize the site of origin of the disease within the maxillary sinus. Early treatment can thus be provided, sometimes before the tumor can be identified radiologically.


Subject(s)
Carcinoma/classification , Maxillary Sinus Neoplasms/classification , Paranasal Sinus Neoplasms/classification , Carcinoma/pathology , Humans , Maxillary Sinus/pathology , Maxillary Sinus Neoplasms/pathology
15.
Ann Otol Rhinol Laryngol ; 96(2 Pt 1): 137-41, 1987.
Article in English | MEDLINE | ID: mdl-3566055

ABSTRACT

Of the many proposed classifications for staging maxillary sinus cancer, none has been adopted universally and none is known to be superior to the others. This study identified the best of six currently used classifications using data from 53 previously untreated patients with squamous cell carcinoma of the maxillary sinus. Analysis of each classification's ability to stage the majority of patients, produce a balanced distribution of T stages, and correlate T stage with treatment and prognosis revealed Harrison's classification to be the best. Harrison's classification should be adopted worldwide as the classification of choice for staging squamous cell carcinoma of the maxillary sinus.


Subject(s)
Carcinoma, Squamous Cell/classification , Maxillary Sinus Neoplasms/classification , Paranasal Sinus Neoplasms/classification , Algorithms , Carcinoma, Squamous Cell/pathology , Humans , Maxillary Sinus Neoplasms/pathology , Neoplasm Staging , Prognosis
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