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1.
J Laryngol Otol ; 134(3): 191-196, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32160940

RESUMO

BACKGROUND: Advances in immunohistochemistry have spearheaded major developments in our understanding and classification of sinonasal tumours. In the last decade, several new distinct histopathological entities of sinonasal cancer have been characterised. OBJECTIVES: This review aims to provide a clinical update of the major emerging subtypes for the ENT surgeon and an overview of the management strategies available for this heterogeneous group of pathologies. CONCLUSION: Although rare, knowledge of sinonasal neoplasm subtypes has implications for prognosis, treatment strategies and the development of novel therapeutic targets.


Assuntos
Neoplasias dos Seios Paranasais , Humanos , Imuno-Histoquímica , Otolaringologia , Procedimentos Cirúrgicos Otorrinolaringológicos , Neoplasias dos Seios Paranasais/patologia , Fenótipo , Prognóstico
2.
J Comput Assist Tomogr ; 44(1): 70-74, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31939885

RESUMO

PURPOSE: The aim of this study was to determine the valuable magnetic resonance imaging (MRI) features of sinonasal metastatic clear-cell renal cell carcinoma (cc-RCC), especially focusing on its dynamic-enhanced characteristics. METHODS: The conventional and dynamic-enhanced MRI findings of 8 patients with histopathologically confirmed sinonasal metastatic cc-RCC were reviewed by 2 radiologists. The control group of 8 patients with capillary hemangioma underwent the same MRI protocol. RESULTS: Metastatic cc-RCCs arose from the nasoethmoid region, maxillary sinus, posterior ethmoid and sphenoid sinus, and nasal cavity in 2 patients in each. These lesions were well circumscribed and the mean maximum dimension was 42 mm. The signal intensity of these lesions was isointense to brain stem on both MR T1- and T2-weighted images. All metastatic tumors showed vivid enhancement on enhanced T1-weighted image. Multiple flow voids within these metastatic lesions were identified in 6 patients. Peripheral cyst was detected around the metastatic tumor in 4 patients. Metastatic cc-RCCs exhibited a characteristic type 4 time intensity curve (TIC) similar to that of the internal carotid artery, whereas capillary hemangiomas showed a type 3 TIC on dynamic-enhanced MRI. CONCLUSIONS: A hypervascular mass with the characteristic type 4 TIC in the sinonasal region is highly suggestive of a metastatic cc-RCC.


Assuntos
Carcinoma de Células Renais/diagnóstico por imagem , Neoplasias Renais/diagnóstico por imagem , Cavidade Nasal/patologia , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/secundário , Idoso , Carcinoma de Células Renais/patologia , Detecção Precoce de Câncer , Feminino , Humanos , Neoplasias Renais/patologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Cavidade Nasal/diagnóstico por imagem , Neoplasias dos Seios Paranasais/patologia , Período Pré-Operatório , Intensificação de Imagem Radiográfica
3.
Artigo em Chinês | MEDLINE | ID: mdl-31954383

RESUMO

Objective: To discuss the treatment, pathological subtypes and recurrence of sinonasal chondrosarcoma, and to identify the prognostic factors. Methods: Between January 1994 and May 2018, 47 patients with sinonasal chondrosarcoma who were treated in Eye, Ear, Nose and Throat Hospital, Shanghai Medwal College, Fudan University were retrospectively reviewed, including 19 males and 28 females, aging from 7 months to 71 years old, with a median age of 38 years old. The clinical symptoms, location of tumor, surgical method, pathological subtype, recurrence and prognosis were collected and analyzed. Kaplan-Meier method was used to calculate the disease-specific survival rate, disease-free survival rate and draw survival curve. Log Rank was used to analyze the prognostic factors. Cox regression was used for multivariate analysis. Results: Except for one patient who gave up treatment after tumor biopsy, other 46 patients underwent radical resection, including 31 cases of endoscopic resection and 15 cases of extranasal approach resection. Thirty-nine patients were diagnosed as conventional intramedullary chondrosarcoma with pathological grade Ⅰ of 24 cases and grade Ⅱ of 15 cases. Six cases were diagnosed as mesenchymal chondrosarcoma while 2 cases were diagnosed as myxoid chondrosarcoma. During an average follow-up period of 56.1 months (17-156 months), 23 patients had recurrence (54.8%, 23/42), among whom 9 patients had re-operations and 5 patients died. Thirty-seven patients survived, including 25 patients survived without tumors. In addition, 5 patients were lost to follow-up, including the patient who gave up treatment after tumor biopsy. Five-year overall survival rate and disease-free survival rate was 84.7% and 34.3%, respectively. Multivariate analysis showed that invasion of skull base was an independent risk factor affecting disease-free survival rate (95% confidence interval: 1.089-5.825, P=0.031). Conclusions: Radical resection is the primary treatment for sinonasal chondrosarcoma. The most common pathological subtype is conventional intramedullary chondrosarcoma. Sinonasal chondrosarcoma has a high local recurrence rate. The long-term prognosis is well after complete excision of the lesion. The most important cause of death is uncontrollable local disease and invasion of adjacent key structures.


Assuntos
Condrossarcoma/patologia , Condrossarcoma/terapia , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/terapia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Prognóstico , Estudos Retrospectivos , Adulto Jovem
4.
World Neurosurg ; 133: 260-265, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31605847

RESUMO

BACKGROUND: Coexistence of sinonasal and skull base tumors is uncommon but possible, and the endonasal route seems to be the best option to manage both lesions simultaneously. We report the first case in the English literature of concomitant sphenoid sinus inverted papilloma and pituitary macroadenoma treated through an endoscopic endonasal approach. CASE DESCRIPTION: A 68-year-old man presented with a history of progressive visual loss and nasal obstruction. Clinical examination disclosed bitemporal hemianopsia. Computed tomography scan and magnetic resonance imaging obtained on admission showed a large sellar/suprasellar enhancing lesion with a marked mass effect on the optic chiasm. Imaging also showed a second mass extending from the sphenoid sinus to the left nasal cavity with obstruction of the maxillary sinus ostium and development of maxillary sinus mucocele. Both tumors were entirely resected by an endoscopic endonasal approach. Additionally, middle meatal antrostomy and marsupialization with drainage of the maxillary mucocele was performed. Biopsy confirmed the coexistence of a pituitary macroadenoma and sphenoid sinus inverted papilloma. CONCLUSIONS: This case and the literature suggest that patients with concomitant nasal and skull base pathologies can be simultaneously managed. The otolaryngologist plays an essential role in removing the sinonasal lesion to ensure a safe surgical corridor before entering the intracranial cavity and for planning for the skull base reconstruction.


Assuntos
Adenoma/cirurgia , Neoplasias Primárias Múltiplas/cirurgia , Papiloma Invertido/cirurgia , Neoplasias dos Seios Paranasais/cirurgia , Neoplasias Hipofisárias/cirurgia , Seio Esfenoidal/cirurgia , Adenoma/diagnóstico por imagem , Adenoma/patologia , Idoso , Humanos , Imagem por Ressonância Magnética , Masculino , Cirurgia Endoscópica por Orifício Natural/métodos , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Neoplasias Primárias Múltiplas/patologia , Neuroendoscopia/métodos , Papiloma Invertido/diagnóstico por imagem , Papiloma Invertido/patologia , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/patologia , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/patologia , Seio Esfenoidal/diagnóstico por imagem , Seio Esfenoidal/patologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
5.
Tumori ; 106(1): 39-46, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31451102

RESUMO

BACKGROUND: We evaluated the prognostic role of gross tumor volumes (GTVs) of primary tumor and positive lymph nodes on overall survival (OS) and progression-free survival (PFS) in locally advanced unresectable sinonasal cancer (SNC) treated with definitive intensity-modulated radiotherapy (IMRT) with or without chemotherapy. METHODS: Primary tumor GTV (GTV-T), pathologic neck nodes GTV (GTV-N), and positive retropharyngeal nodes GTV (GTV-RPN) of 34 patients with epithelial nonglandular SNC receiving IMRT with or without chemotherapy were retrospectively measured. The GTV variables were analyzed in relation with OS and PFS. Survival curves were estimated using the Kaplan-Meier method and compared with the log-rank test. We also estimated the crude cumulative incidence of locoregional relapses only. The optimal volume cutoff value was determined using an outcome-oriented method among the observed values. RESULTS: GTV-T was significantly associated with decreased OS (P=0.003) and PFS (P=0.003). Moreover, patients with disease total volumes (GTV) smaller than 149.44 cm³ had better OS and PFS than patients with higher volumes (P<0.0001 for both). Neck nodal metastasis impacted on OS and PFS (P=0.030 and P=0.033, respectively), but GTV-N did not (P=0.961; P=0.958). Retropharyngeal nodes metastasis was not associated with prognosis (OS: P=0.400; PFS: P=0.104). When GTV-RPN was added to GTV-N (GTV-TN), a relation with PFS (P=0.041) and a trend toward significance for OS (P=0.075) were found. CONCLUSIONS: Our results show that tumor volume is a powerful predictor of outcome in SNC. This could be useful to identify patients with worse prognosis deserving different treatment strategies.


Assuntos
Neoplasias dos Seios Paranasais/mortalidade , Neoplasias dos Seios Paranasais/patologia , Neoplasias Faríngeas/mortalidade , Neoplasias Faríngeas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Terapia Combinada , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias dos Seios Paranasais/terapia , Neoplasias Faríngeas/terapia , Prognóstico , Modelos de Riscos Proporcionais , Radiometria , Dosagem Radioterapêutica , Radioterapia de Intensidade Modulada/efeitos adversos , Radioterapia de Intensidade Modulada/métodos , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento , Carga Tumoral
6.
Pan Afr Med J ; 34: 71, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31819787

RESUMO

Introduction: Inverted Papilloma (IP) is a rare benign tumour of the nose and paranasal sinuses histologically characterized by invagination of the outer layer of the epithelium in the underlying chorion. Its most distinctive feature is a strong local aggressiveness, a tendency to recur and an unpredictable risk of association with epidermoid carcinoma. The purpose of this study was to report the epidemiological, clinical, paraclinical data as well as to assess the outcomes of endoscopic endonasal surgery. Methods: We conducted a retrospective study on a series of 13 patients whose data were collected in the Oto-Rhino-Laryngology at the National University Hospital Center of Fann, from 1st January 2012 to 31st December 2017. All patients followed up for inverted papilloma confirmed by anathomopathological examination were included in the study. Results: The average age of patients was 44 years, the sex-ratio was 2.25. All patients had nasal obstruction; 53% of them had rhinorrhea followed by epistaxis in 30% of cases. Right-sided symptoms were reported by 69% of patients, left-sided symptoms by 23% and bilateral symptoms by 7% of patients. Anterior rhinoscopy showed endonasal mass in all patients. All patients underwent CT scan; the MRI was performed in a single patient. Endoscopic resection of IP was performed in 10 patients (76.9%) while external approach was used in 23% of cases. Surgery helped to clarify where the tumor had originated: in 46% of cases in the maxillary sinus, in 15% in the lower nasal turbinate, in 15% in the mid-turbinate, in 7% in the ethmoid bulla and in 7% in the lateral wall of the nasal fossa. One patient had recurrence after an average period of 26 months. Malignant transformation to squamous cell carcinoma occurred in one patient. Conclusion: Inverted papilloma is a very aggressive tumor. CT scan is essential to highlight its spread, especially to bone. The advent of endoscopic surgery has revolutionised treatment, providing excellent results. But, there is nevertheless a risk of recurrence after surgery which motivates an indication for long term monitoring.


Assuntos
Neoplasias do Seio Maxilar/epidemiologia , Neoplasias Nasais/epidemiologia , Papiloma Invertido/epidemiologia , Neoplasias dos Seios Paranasais/epidemiologia , Adulto , Idoso , Carcinoma de Células Escamosas/diagnóstico , Feminino , Hospitais Universitários , Humanos , Imagem por Ressonância Magnética , Masculino , Neoplasias do Seio Maxilar/diagnóstico , Neoplasias do Seio Maxilar/patologia , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/patologia , Papiloma Invertido/diagnóstico , Papiloma Invertido/patologia , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/patologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
7.
Orv Hetil ; 160(40): 1584-1590, 2019 Oct.
Artigo em Húngaro | MEDLINE | ID: mdl-31565974

RESUMO

Introduction: Malignant tumours of the sinonasal region - including those with invasion of the skull base - necessitate surgical resection. The majority of the cases give an opportunity to perform the procedure via minimally invasive, endoscopic approach, without external, craniofacial surgery. Aim: To assess our clinical experience in treating anterior skull base malignancies, performing minimally invasive endoscopic transcribriform resection. Method: Between February 2015 and July 2017, four male and one female patient underwent minimally invasive, endoscopic skull base procedure. The mean age was 64.6 years (59-70, median: 66). Every surgery was performed via transnasal, endoscopic transcribriform approach. In two cases Kadish C esthesioneuroblastomas, while in one case a T3N0 sinonasal non-differentiated carcinoma, a T1N0 intestinal type adenocarcinoma and a T4N0 squamous cell carcinoma was the indication of surgery, respectively. Results: The mean follow-up time was 22.8 months, between 14 and 46 months. Intraoperative complications did not occur during the procedures. Regarding the postoperative period, liquorrhoea and pneumocephalus occurred in one case. Complications were solved with lumbar drainage. During follow-up, neither residual nor recurrent tumour was observed in our patients. Conclusion: Endoscopic transcribriform resection of the skull base malignancies is a safe and viable alternative to the traditional open approach. Orv Hetil. 2019; 160(40): 1584-1590.


Assuntos
Endoscopia , Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação , Neuroendoscopia/métodos , Procedimentos Neurocirúrgicos/métodos , Neoplasias dos Seios Paranasais/cirurgia , Neoplasias da Base do Crânio/cirurgia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Recidiva Local de Neoplasia , Neuroendoscopia/efeitos adversos , Neoplasias dos Seios Paranasais/patologia , Base do Crânio/cirurgia , Neoplasias da Base do Crânio/patologia , Resultado do Tratamento
8.
J Clin Exp Hematop ; 59(3): 101-107, 2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31391402

RESUMO

The present study investigated histological subtypes of lymphoma in patients newly diagnosed with malignant lymphoma in the human T-cell leukemia virus type 1 (HTLV-1) endemic area of Japan, and further analyzed the clinicopathological features and clinical outcomes of patients with primary sinonasal lymphoma. We retrospectively examined 151 patients aged 18-90 years in Fukuoka, Japan. Subtypes of lymphoma were determined according to the WHO classification. Among the 151 patients, 104 were diagnosed with malignant lymphoma, including 96 at the time of initial diagnosis. Ninety-two of the 96 lymphomas (96%) were non-Hodgkin lymphoma. Mature B-cell neoplasms comprised 78% (n = 75). Primary lymphoma of the sinonasal cavity was found in six patients (6%). The histological subtype of sinonasal lymphoma was diffuse large B-cell lymphoma (DLBCL) in all six tumors. Furthermore, overall survival was significantly different among three distinct DLBCL patient groups, including primary sinonasal lymphoma patients (p = 0.0016; 3-year overall survival: sinonasal DLBCL group, 53%; DLBCL of the CNS group, 0%; other DLBCL group, 83%). Our study suggests that primary DLBCL of the sinonasal tract is a distinct disease entity of DLBCL.


Assuntos
Vírus Linfotrópico T Tipo 1 Humano , Linfoma Difuso de Grandes Células B , Neoplasias dos Seios Paranasais , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Feminino , Humanos , Japão/epidemiologia , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/mortalidade , Linfoma Difuso de Grandes Células B/patologia , Linfoma Difuso de Grandes Células B/terapia , Masculino , Pessoa de Meia-Idade , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/mortalidade , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/terapia , Estudos Retrospectivos , Taxa de Sobrevida
9.
BMC Cancer ; 19(1): 827, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31438887

RESUMO

BACKGROUND: SMARCB1-deficient sinonasal carcinoma (SDSC) is an aggressive subtype of head and neck cancers that has a poor prognosis despite multimodal therapy. We present a unique case with next generation sequencing data of a patient who had SDSC with perineural invasion to the trigeminal nerve that progressed to a brain metastasis and eventually leptomeningeal spread. CASE PRESENTATION: A 42 year old female presented with facial pain and had resection of a tumor along the V2 division of the trigeminal nerve on the right. She underwent adjuvant stereotactic radiation. She developed further neurological symptoms and imaging demonstrated the tumor had infiltrated into the cavernous sinus as well as intradurally. She had surgical resection for removal of her brain metastasis and decompression of the cavernous sinus. Following her second surgery, she had adjuvant radiation and chemotherapy. Several months later she had quadriparesis and imaging was consistent with leptomeningeal spread. She underwent palliative radiation and ultimately transitioned quickly to comfort care and expired. Overall survival from time of diagnosis was 13 months. Next generation sequencing was carried out on her primary tumor and brain metastasis. The brain metastatic tissue had an increased tumor mutational burden in comparison to the primary. CONCLUSIONS: This is the first report of SDSC with perineural invasion progressing to leptomeningeal carcinomatosis. Continued next generation sequencing of the primary and metastatic tissue by clinicians is encouraged toprovide further insights into metastatic progression of rare solid tumors.


Assuntos
Carcinoma/etiologia , Carcinoma/patologia , Neoplasias dos Seios Paranasais/etiologia , Neoplasias dos Seios Paranasais/patologia , Proteína SMARCB1/deficiência , Adulto , Biomarcadores Tumorais , Carcinoma/diagnóstico por imagem , Progressão da Doença , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Imuno-Histoquímica , Carcinomatose Meníngea/diagnóstico , Carcinomatose Meníngea/secundário , Metástase Neoplásica , Estadiamento de Neoplasias , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Polimorfismo de Nucleotídeo Único , Tomografia Computadorizada por Raios X
10.
Eur Arch Otorhinolaryngol ; 276(11): 3113-3122, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31451900

RESUMO

PURPOSE: Definitive radiotherapy (RT) is recommended by NCCN guidelines for T4b tumors of sinonasal squamous cell carcinomas (SNSCC). However, no multi-institutional clinical studies have proved its advantage over surgery-based modalities. The aim of this study was to assess the survival of T4bN0M0 SNSCC patients who received surgery plus postoperative radiation (S + PORT) compared with those who received RT. METHODS: This study extracted 220 patients from the SEER database from 2004 to 2015. Propensity score matching (PSM) was used to eliminate the baseline variations. RESULTS: In SEER database, 43.6% of patients received S + PORT, and subsequently followed by RT (36.4%). Five-year overall survival (OS) and cancer-specific survival rates (CSS) in S + PORT were 42.5% and 46.9%, respectively, significantly better than for RT (21.7% and 26.7%). Multivariate analysis showed that therapy of RT had higher cancer-specific mortality risk than S + PORT [hazard ratio (HR) 1.578, p = 0.032]. After PSM, 57 pairs of patients were selected. There was still a significant difference noted with regard to 5-year OS or 5-year CSS between patients receiving S + PORT and RT (43% vs 22.5%, p = 0.012; 45.8% vs 27.7%, p = 0.025). The univariate and multivariate analyses of factors predictive of CSS showed that therapy of RT (HR 1.877, p = 0.018) and primary subsite of maxillary sinus (HR 2.629, p = 0.001) were significantly correlated with adverse outcomes. CONCLUSION: Combination of surgery and postoperative radiotherapy may contribute to prolonged survival in T4bN0M0 SNSCC. Invasion of the sites of T4b tumors is not an absolute contraindication for surgery.


Assuntos
Carcinoma de Células Escamosas , Cirurgia Endoscópica por Orifício Natural , Neoplasias dos Seios Paranasais , Radioterapia , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , China/epidemiologia , Terapia Combinada/métodos , Terapia Combinada/estatística & dados numéricos , Pesquisa Comparativa da Efetividade , Tratamento Conservador/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cirurgia Endoscópica por Orifício Natural/efeitos adversos , Cirurgia Endoscópica por Orifício Natural/métodos , Cirurgia Endoscópica por Orifício Natural/estatística & dados numéricos , Estadiamento de Neoplasias , Neoplasias dos Seios Paranasais/mortalidade , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/terapia , Radioterapia/efeitos adversos , Radioterapia/métodos , Radioterapia/estatística & dados numéricos , Programa de SEER/estatística & dados numéricos , Taxa de Sobrevida
11.
J Craniofac Surg ; 30(7): e622-e623, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31157640

RESUMO

Osteomas are benign, slow-growing tumors originating from bone tissue. Osteomas of the paranasal region, which are usually asymptomatic, are detected incidentally on tomographies taken for other medical needs. Paranasal sinus osteomas frequently localized in the frontal and ethmoid sinuses are among the infrequent reasons for headaches. In this case report, the authors submit the first case of an osteoma that was localized inside the middle concha bullosa and causing headache. It was successfully excised via an endoscopic endonasal approach without any complications.


Assuntos
Seio Etmoidal/cirurgia , Cefaleia/etiologia , Neoplasias Nasais/cirurgia , Osteoma/cirurgia , Neoplasias dos Seios Paranasais/cirurgia , Adolescente , Humanos , Masculino , Neoplasias Nasais/complicações , Neoplasias Nasais/diagnóstico por imagem , Neoplasias Nasais/patologia , Osteoma/complicações , Osteoma/diagnóstico por imagem , Osteoma/patologia , Neoplasias dos Seios Paranasais/complicações , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/patologia , Tomografia Computadorizada por Raios X
12.
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 33(5): 447-450;454, 2019 May.
Artigo em Chinês | MEDLINE | ID: mdl-31163555

RESUMO

Objective: To investigate the clinicopathological features and the clinical characteristics of inflammatory myofibroblastic tumor(IMT) of paranasal sinus. Method: Five cases of IMT of paranasal sinus treated from 2011 to 2018 were analyzed retrospectively. Of the 5 patients, CT and MRI were performed before operation. All tumors originated from paranasal sinus, and orbital, pterygopalatine fossa and palate was involved with variable degrees. All patients had been given operation and recovered well. Two cases received additional glucocorticoid therapy(prednisone) postoperatively. Result: After a follow-up of 3-80 months, one case recurred 2 years postoperatively and received surgery again. No recurrence was found after operation in the other four patients. The finial diagnosis depended on pathological findings. Postoperative pathological examination showed that the tumor cells were mainly composed of spindle fibroblasts and chronic inflammatory cells. Immunohistochemical staining showed positive expression of SMA protein. Conclusion: IMT of paranasal sinus is a rare clinical entity without specific clinical manifestations and the extent of the lesion can be assessed by imaging examinations. Pathological examination is required for final diagnosis. Radical resection should be taken for limited lesions. Besides surgery, corticosteroid administration and irradiation therapy is recommended in some circumstances. The overall prognosis is good.


Assuntos
Neoplasias dos Seios Paranasais/cirurgia , Humanos , Recidiva Local de Neoplasia , Neoplasias dos Seios Paranasais/patologia , Seios Paranasais/patologia , Seios Paranasais/cirurgia , Prednisona/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento
14.
Rev. esp. patol ; 52(2): 125-129, abr.-jun. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-182700

RESUMO

La enfermedad relacionada con IgG4 (ER-IgG4) es un proceso patológico que ha unificado un gran número de enfermedades consideradas como propias de distintos órganos cuya etiopatogenia se desconocía. Su diagnóstico se establece mediante criterios histológicos, radiológicos y serológicos. El tratamiento se basa en corticoides durante tiempo prolongado, reservándose el uso de rituximab para casos refractarios. Es extremadamente inusual que esta entidad asiente solo en cabeza y cuello sin afectación sistémica, por lo que hay pocos casos como el que presentamos descritos en la literatura. Exponemos el caso de una paciente con una tumoración orbitaria con afectación de senos paranasales, diagnosticada de ER-IgG4 nasosinusal. La precisión del diagnóstico propició el inicio precoz de tratamiento corticoideo. En la actualidad la paciente se encuentra asintomática


IgG4 related disease (igG4-RD) is a pathological process which integrates a large number of diseases of unknown pathogenesis, considered as being exclusive to many different organs. Diagnosis is established through histological, radiological and serological criteria. Treatment is based on long term corticosteroids; rituximab being used only in refractory cases. It is unusual for this entity to be found exclusively in the head and neck, without systemic involvement; there are only a few reported cases to date. We present a case of a nasosinusal IgG4-RD orbital tumor with paranasal sinus involvement. The accurate diagnosis made early onset corticosteroid treatment possible and the patient is currently asymptomatic


Assuntos
Humanos , Feminino , Idoso , Doença Relacionada a Imunoglobulina G4/patologia , Neoplasias dos Seios Paranasais/patologia , Neoplasias Orbitárias/patologia , Fibrose/patologia , Invasividade Neoplásica/patologia , Achados Incidentais
15.
Pathol Res Pract ; 215(7): 152439, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31076280

RESUMO

In this study we investigated the expression of mucins (MUC1, MUC2, MUC4, MUC5AC and MUC6) in a series of 66 sinonasal adenocarcinomas, in order to establish their distribution and the possible correlation with clinicopathological and prognostic parameters. The series included 51 intestinal type adenocarcinomas, 4 non-intestinal type adenocarcinomas, and 11 salivary gland type carcinomas. The immunohistochemical analysis was conducted on a tissue microarray obtained from formalin fixed-paraffin embedded tumor tissue samples. Thirty-nine adenocarcinomas (59.1%) resulted positive for MUC1, 21 (41.2%) for MUC2, 47 (71.2%) for MUC4, and 16 (24.2%) for MUC5AC, while MUC6 was negative in all cases tested. MUC1 was significantly more expressed in ITACs than in non-ITACs (70% vs 20%, p = 0.0007) while MUC2 was expressed only in ITACs (p = 0.0015) with a clear prevalence in the mucinous subtype (p < 0.0001). Conversely, MUC4 and MUC5AC were similarly expressed in the sinonasal adenocarcinoma subtypes tested. High expression of MUC 1 was related to a significantly shorter overall survival, both in the whole series (p = 0.04), while adenocarcinomas positive for MUC 2 tended to have a worse overall survival (p = 0.07). In addition, MUC2 expression was higher in ITACs with distant metastasis, being expressed in 4 out of 5 cases (p = 0.015). We conclude that sinonasal adenocarcinomas have a characteristic expression of different mucin types, with significant clinicopathologic correlations. In view of the extensive involvement of mucins in different aspects of tumor growth and their emerging role as possible therapeutic targets, our study suggests that these factors could be considered clinically relevant biomarkers and attractive targets for new treatments in sinonasal adenocarcinomas.


Assuntos
Adenocarcinoma/metabolismo , Mucinas/metabolismo , Neoplasias dos Seios Paranasais/metabolismo , Neoplasias das Glândulas Salivares/metabolismo , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Neoplasias dos Seios Paranasais/mortalidade , Neoplasias dos Seios Paranasais/patologia , Prognóstico , Neoplasias das Glândulas Salivares/mortalidade , Neoplasias das Glândulas Salivares/patologia , Taxa de Sobrevida
16.
Acta Cytol ; 63(5): 431-437, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31132763

RESUMO

SMARCB1 (INI-1)-deficient sinonasal carcinoma is a rare entity within the subgroup of poorly differentiated sinonasal tract carcinomas. As there are only two papers describing the cytologic features of this entity, herein we describe the unique cytomorphologic features of a pulmonary metastasis of this tumor and include the differential diagnosis based on tumor location. The patient was a 53-year-old male who initially presented with sinus congestion and vision changes including left-eye proptosis and diplopia. The initial biopsy of the ethmoid-centered sinonasal mass was non-keratinizing squamous cell carcinoma based on strong immunoreactivity with p40 and absence of immunoreactivity for chromogranin, synaptophysin, p16, and EBER. However, the final diagnosis of the surgical resection was amended to SMARCB1 (INI-1)-deficient sinonasal carcinoma after additional immunohistochemical stains were performed. Post-primary resection, follow-up computed tomography imaging revealed significant interval progression of a solitary, initially indeterminate 1-cm lung nodule in the left upper lobe. Endobronchial ultrasound-guided fine-needle aspiration with concomitant core-needle biopsy was performed. Rapid on site evaluation of cytologic smears revealed a hypercellular specimen consisting of sheets of epithelioid cells with very scant to absent cytoplasm, ill-defined cell borders, enlarged fragile nuclei, and areas of nuclear molding. Mitotic figures were present. Other areas showed tumor cells with spindled to elongated nuclei and scant to ill-defined wispy cytoplasm. Both cytology cell block and core-needle biopsy histopathologic material showed the tumor cells to be negative for INI-1 nuclear staining as well as CK5/6, CAM5.2, p40, p63, CK7, AE1/3, and TTF-1. SMARCB1 (INI-1)-deficient sinonasal carcinoma can have a spectrum of morphologies and may mimic "small-round-blue-cell" and spindle-cell tumors on cytology preparations. Given the pulmonary location of the aspirate, familiarity with the cytomorphologic spectrum of SMARCB1 (INI-1)-deficient sinonasal carcinoma, inclusion of this entity within the differential diagnosis, and performance of immunohistochemistry will aid in arriving at the correct diagnosis.


Assuntos
Biomarcadores Tumorais/deficiência , Carcinoma/química , Carcinoma/secundário , Diferenciação Celular , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Neoplasias dos Seios Paranasais/química , Neoplasias dos Seios Paranasais/patologia , Proteína SMARCB1/deficiência , Carcinoma/cirurgia , Diagnóstico Diferencial , Predisposição Genética para Doença , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Neoplasias dos Seios Paranasais/cirurgia , Fenótipo , Valor Preditivo dos Testes , Reprodutibilidade dos Testes
17.
Pathol Res Pract ; 215(6): 152432, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31047725

RESUMO

Given that the prognosis of patients with sinonasal intestinal-type adenocarcinoma (ITAC) has not significantly changed recently, there is a desire for new therapeutic approaches to improve clinical management. HER2-targeted therapy has remarkably improved the overall survival of patients with HER2 amplified tumors. To date, HER2 assessment has produced contradictory results in ITAC. The aim of this study was to assess HER2 status at both protein and DNA levels in a large series of ITAC. HER2 status was assessed by immunohistochemistry (IHC) and chromogenic in situ hybridization (CISH) in forty-three patients that underwent surgical resection for ITAC at the Otorhinolaryngology Section, Padua University Hospital, between 2007 and 2016. IHC was evaluated using the four-tier score developed for gastroesophageal cancer. As for IHC, 83.7% (36/43) of ITAC were scored 0, 14% (6/43) 1+, and 2.3% (1/43) 2+. No HER2 amplification was detected by CISH. The present is the largest study of sinonasal ITAC tested with both IHC and CISH confirmation for HER2 status. No HER2 overexpression/amplification was detected. Contrary to previous studies, our findings seem to rule out any oncogenetic role of HER2 in ITAC pathogenesis.


Assuntos
Adenocarcinoma/metabolismo , Neoplasias dos Seios Paranasais/metabolismo , Receptor ErbB-2/metabolismo , Adenocarcinoma/patologia , Biomarcadores Tumorais/metabolismo , Humanos , Neoplasias dos Seios Paranasais/patologia
18.
Eur Arch Otorhinolaryngol ; 276(8): 2259-2265, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31098872

RESUMO

PURPOSE: To present outcome measures of sinonasal mucosal melanoma (SMM) patients with particular focus on current radiological and therapeutic options, especially in the non-curative setting (immunotherapy). METHODS: Retrospective study on SMM patients treated at our institution between January 1992 and December 2018. RESULTS: FDG-PET/MRI has emerged as the new hybrid imaging modality, addressing the need for high local tissue contrast in the paranasal sinuses and the skull base, while allowing for whole-body staging in search for distant metastases, including the brain. Primary treatment protocols consisted of tumor resection in 30/34 patients (88%), palliative radiation therapy (RT) in 3/34 patients (9%) and best supportive care therapy in 1/34 patient (3%). Of all the initially operated patients, 25/30 patients (83%) received adjuvant RT. A total of 9/34 patients (26%) was treated with immunotherapy after the previous combined therapy. For patients treated in curative intention, we observed a 1-year overall survival (OS) of 60% (18/30 patients) and a 3-year OS of 40% (12/30 patients). For patients treated with immunotherapy, median progression-free survival (PFS) was 5 months (IQR 0-13.75), with a maximum PFS of 16 months (combination of nivolumab and ipilimumab). However, there was no difference in OS in patients treated with immunotherapy vs. no immunotherapy (log rank 0.99). CONCLUSIONS: Sinonasal mucosal melanoma is a highly aggressive tumor, requiring multimodal therapy and developing a substantial incidence of distant metastases. The introduction of FDG-PET/MRI offers new possibilities in the radiological assessment of the tumor and immunotherapy has altered the management in the non-curative setting, resulting in a substantial progression-free survival in selected cases.


Assuntos
Imunoterapia/métodos , Ipilimumab/uso terapêutico , Melanoma , Nivolumabe/uso terapêutico , Neoplasias dos Seios Paranasais , Radioterapia/métodos , Idoso , Antineoplásicos Imunológicos/uso terapêutico , Terapia Combinada , Feminino , Humanos , Masculino , Melanoma/epidemiologia , Melanoma/patologia , Melanoma/terapia , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Imagem Multimodal/estatística & dados numéricos , Mucosa Nasal/patologia , Estadiamento de Neoplasias , Neoplasias dos Seios Paranasais/epidemiologia , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/terapia , Intervalo Livre de Progressão , Estudos Retrospectivos , Suíça/epidemiologia
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