Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.969
Filtrar
1.
J Cancer Res Clin Oncol ; 147(4): 1019-1027, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33051725

RESUMO

PURPOSE: The purpose of our study was to compare genomic changes in sinonasal intestinal-type adenocarcinoma (sITAC) and colorectal adenocarcinoma (CRC), as they are histomorphologically indistinguishable. This can cause diagnostic difficulties as sinonasal tumours initially diagnosed as sITAC may represent metastasis from CRC, a frequent cancer. Previous studies have not uncovered the underlying mechanism behind the histomorphological resemblance. METHODS/PATIENTS: Tissue samples from all consecutive patients with sITAC at our facility (20 patients) were compared to samples from 20 patients with CRC as well as samples from 2 patients with both CRC and sinonasal tumours. DNA sequencing was performed using Illumina TruSight Oncology 500 panel consisting of 523 cancer-associated genes. Frequent mutations were inspected manually using the Integrative Genomics Viewer. RESULTS: Several well-known cancer-associated genes were mutated in the CRC group, but also in the sinonasal ITAC group. These genes included APC mutated in 65% of the CRC group and 37% of the sinonasal ITAC group, and TP53 mutated in 65% of CRC samples and 58% of ITAC samples. These shared mutations may explain the histomorphological similarities. Successful DNA sequencing was performed on the colorectal sample from one of the two patients with both CRC and sinonasal tumour. Comparing mutations in these samples from one patient we have shown that the sinonasal tumour in all probability was a CRC metastasis. CONCLUSION: We have identified several genetic similarities between sITAC and CRC. This discovery brings us closer to understanding mechanisms behind the development of sITAC-and hopefully in the future targeted therapy.


Assuntos
Adenocarcinoma/patologia , Biomarcadores Tumorais/genética , Neoplasias Colorretais/patologia , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Mutação , Neoplasias dos Seios Paranasais/patologia , Adenocarcinoma/genética , Neoplasias Colorretais/genética , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias dos Seios Paranasais/genética , Prognóstico , Estudos Retrospectivos
3.
J Comput Assist Tomogr ; 45(1): 135-141, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32649429

RESUMO

PURPOSE: The purpose of this study was to explore the characteristic computed tomography (CT) and magnetic resonance (MR) features of small cell neuroendocrine carcinoma (SNEC) of paranasal sinuses. MATERIALS AND METHODS: Computed tomography (n = 8) and MR (n = 14) images and clinical findings from 14 patients with SNEC of paranasal sinuses were retrospectively reviewed. RESULTS: Eight lesions were located in the ethmoidal sinus, 4 in the maxillary sinus, and 2 in the sphenoid sinus. Small cell neuroendocrine carcinoma of the sphenoid sinus showed bilateral asymmetry patterns. On CT images, bony changes were visible in all 8 cases. On MR, 4 cases contained hemorrhage, and 10 cases contained cystic or necrotic areas. All cases demonstrated marked heterogeneous enhancement, with half showing a "cribriform-like" or "geographic" appearance. The nasal cavity was the most common site invaded by SNEC of paranasal sinuses, followed by the orbits. A time-signal intensity curve examination showed a washout-type pattern in all but 1 case. The mean ± SD apparent diffusion coefficient value was 0.702 ± 0.112 (×10-3 mm2/s). According to the Dulguerov staging system, 9 tumors were staged as N0 (1 T1, 1 T2, 5 T3, and 2 T4). The recurrence rate was 64.3%. CONCLUSIONS: Some characteristics of radiological findings can provide important clues for preoperative diagnosis.


Assuntos
Carcinoma Neuroendócrino/diagnóstico por imagem , Carcinoma de Células Pequenas/diagnóstico por imagem , Seio Etmoidal/patologia , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Seio Esfenoidal/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Neuroendócrino/patologia , Carcinoma de Células Pequenas/patologia , Seio Etmoidal/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias dos Seios Paranasais/patologia , Período Pré-Operatório , Estudos Retrospectivos , Sensibilidade e Especificidade , Seio Esfenoidal/diagnóstico por imagem , Tomografia Computadorizada por Raios X
4.
Laryngoscope ; 131(5): E1468-E1475, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-32946597

RESUMO

OBJECTIVES: To evaluate the incidence of histopathologic diagnostic discrepancy for patients referred to our institution, identify pathologies susceptible to diagnostic error, and assess the impact on survival of histopathologic diagnostic discrepancies. METHODS: Three hundred ninety-seven patients with sinonasal cancers were identified, and discordance between the outside pathologic report and MD Anderson Cancer Center pathologic report was assessed. Overall survival and disease-specific survival were analyzed using Kaplan-Meier and log rank methods. RESULTS: Discordance of major histopathologic diagnoses was present in 24% (97 of 397) of reports, with sinonasal undifferentiated carcinoma, sarcoma, neuroendocrine carcinoma, and poorly differentiated carcinoma pathologies having the highest change in diagnosis (P < .01). A further 61% (244 of 397) had minor changes such as histologic grade, subtype, or stage, with sarcoma and neuroendocrine carcinoma pathologies being most susceptible to change (P < .02). Overall, the 5-year overall survival (OS) and disease-specific survival (DSS) was reduced in patients with a major change in histopathologic diagnosis (59.2% vs. 70.2% (P = .02) and 72.9% vs. 81.2% (P = .02), respectively). Furthermore, patients with a major change in diagnosis and prior treatment experienced a significant reduction in 5-year OS (61.9% vs. 70.4%, P = .03 < .01) and DSS (72.4% vs. 81.5%, P = .04). CONCLUSION: Histopathological diagnosis of sinonasal tumors is complex and challenging given the rarity of the disease. Obtaining the correct diagnosis is important for treatment selection and survival. In histologies prone to misdiagnoses, obtaining a second opinion from experienced head and neck pathologists at a high-volume institution may potentially lead to a change in treatment recommendations that could result in improved survival in patients with sinonasal malignancies. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E1468-E1475, 2021.


Assuntos
Carcinoma Neuroendócrino/diagnóstico , Carcinoma/diagnóstico , Erros de Diagnóstico/estatística & dados numéricos , Neoplasias do Seio Maxilar/diagnóstico , Neoplasias dos Seios Paranasais/diagnóstico , Seios Paranasais/patologia , Sarcoma/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/epidemiologia , Carcinoma/patologia , Carcinoma/terapia , Carcinoma Neuroendócrino/epidemiologia , Carcinoma Neuroendócrino/patologia , Carcinoma Neuroendócrino/terapia , Criança , Pré-Escolar , Erros de Diagnóstico/prevenção & controle , Feminino , Humanos , Incidência , Estimativa de Kaplan-Meier , Masculino , Neoplasias do Seio Maxilar/epidemiologia , Neoplasias do Seio Maxilar/patologia , Neoplasias do Seio Maxilar/terapia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias dos Seios Paranasais/epidemiologia , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/terapia , Encaminhamento e Consulta/estatística & dados numéricos , Estudos Retrospectivos , Sarcoma/epidemiologia , Sarcoma/patologia , Sarcoma/terapia , Adulto Jovem
5.
Virchows Arch ; 478(5): 915-924, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33048186

RESUMO

Inverted (Schneiderian) sinonasal papilloma (ISP) is a neoplasm derived from mucosa of the sinonasal tract characterized by local aggressive growth, a tendency to recur and an association with sinonasal carcinoma. The etiology of ISP remains unclear. Recently, identical mutations in exons 19 and 20 of the oncogene EGFR were reported in ISP and ISP-associated sinonasal carcinoma. Nevertheless, it remains unclear whether recurring ISPs show identical EGFR mutations at different time points or whether these mutations are identical throughout the respective ISP sample. We used Sanger sequencing to test 60 formalin-fixed paraffin embedded ISP samples from 40 patients regarding mutations in exons 19 and 20 of EGFR-together with exon 15 of BRAF. Overall, 32 samples of 22 patients showed a mutation in EGFR exon 20, whereas 28 samples of 18 patients showed none. No mutation in EGFR exon 19 was found in any sample. Four samples of four patients showed a BRAF exon 15 mutation. Interestingly, samples of four patients exhibited genetic heterogeneity, enabling us to report this in ISP for the first time.


Assuntos
Biomarcadores Tumorais/genética , Mutação , Papiloma Invertido/genética , Neoplasias dos Seios Paranasais/genética , Proteínas Proto-Oncogênicas B-raf/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise Mutacional de DNA , Receptores ErbB/genética , Feminino , Heterogeneidade Genética , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Papiloma Invertido/patologia , Neoplasias dos Seios Paranasais/patologia , Fenótipo
6.
Laryngoscope ; 131(4): E1040-E1048, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-32959912

RESUMO

OBJECTIVE: Sinonasal squamous cell carcinoma (SCC) is rare with no consensus on treatment regimen. Our goal is to analyze treatment outcomes in poorly differentiated SCC (PDSCC) using a large national database. STUDY DESIGN: Retrospective database study. METHODS: The National Cancer Database was queried for sinonasal invasive SCC, grade 3 (poorly differentiated) from 2004 to 2014. Patient demographics and tumor and treatment characteristics were tabulated. Kaplan-Meier (KM) analysis was performed to compare overall survival (OS) between histology subtype and primary site. Multivariable Cox proportional hazards regression was performed for statistical analysis of treatment regimen on OS. RESULTS: A total of 1,074 patients were identified. The maxillary sinus was the most common site (45%). T4 tumors were observed in 50% of patients, with most patients treated at high-volume facilities (77%). In KM analysis, spindle cell SCC histological subtype, primary tumors of the maxillary sinus, and poorly differentiated grade had worse OS. In our Cox-PH model, higher T stage and age were associated with worse OS. Those treated at a high-volume facility and those who underwent surgical resection followed by adjuvant radiation had improved OS. Chemotherapy within the treatment regimen did not confer survival benefit except in surgical patients when positive margins were present, and surgery with adjuvant chemoradiation trended toward improved survival. CONCLUSIONS: Sinonasal PDSCC appears to be best treated at high-volume centers with surgical resection followed by adjuvant radiation. Poorly differentiated grade has worse OS compared to more differentiated tumors. Chemotherapy along with adjuvant radiation may have a role in patients with positive surgical margins. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E1040-E1048, 2021.


Assuntos
Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Neoplasias dos Seios Paranasais/mortalidade , Neoplasias dos Seios Paranasais/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Neoplasias dos Seios Paranasais/terapia , Estudos Retrospectivos , Taxa de Sobrevida , Estados Unidos
7.
Cancer Med ; 10(2): 634-641, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33350606

RESUMO

Sinonasal papillomas are characterized by their potential for frequent recurrences and malignant progression. Currently, the role of human papillomavirus (HPV) infection in sinonasal papillomas is unclear. A study was conducted to elucidate the impact of HPV infection on recurrence and malignant progression of sinonasal papillomas. One hundred and seven patients with 151 tumors could be examined. One hundred and one patients suffered from benign papilloma, mostly inverted papillomas (IP); six patients suffered from carcinomas in situ and squamous cell carcinomas (SCC) ex-IP. Recurrent IP were more often HPV-positive than non-recurrent tumors (38.8% vs. 60%-65%). Low-risk (LR) HPV infection (especially HPV 6) increased the risk of tumor recurrences (p = 0.0385 and p = 0.0556, respectively). IP and oncocytic papillomas (both lesions are known for their malignant potential) were more often high-risk (HR) HPV-positive (15.5% and 16.7%) than fungiform papilloma (which usually does not progress to carcinoma). CIS and SCC ex-IP displayed higher HPV rates than benign IP (83.3% vs. 38.8%), especially higher rates of HR-HPV (66.7% vs. 23.8%, p = 0.0415). Data from this study endorse the hypothesis that recurrence of sinonasal papillomas is promoted by LR-HPV infection and that malignant progression of IP is promoted by HR-HPV infection.


Assuntos
Alphapapillomavirus/isolamento & purificação , Papiloma Invertido/epidemiologia , Infecções por Papillomavirus/complicações , Neoplasias dos Seios Paranasais/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Seguimentos , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/patologia , Papiloma Invertido/patologia , Papiloma Invertido/virologia , Infecções por Papillomavirus/virologia , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/virologia , Prognóstico , Estudos Retrospectivos
9.
BMJ Case Rep ; 13(12)2020 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-33318263

RESUMO

Sinonasal glomangiopericytoma is a rare sinonasal tumour accounting for less than. 5% of all sinonasal tumours. This tumour often presents as another, more common type of vascular lesion and is similarly prone to haemorrhage. The optimal treatment includes complete surgical resection. We, herein, present two such cases adding to the world literature of this rare tumour.


Assuntos
Seio Etmoidal/diagnóstico por imagem , Hemangiopericitoma/diagnóstico por imagem , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Seio Esfenoidal/diagnóstico por imagem , Idoso , Diagnóstico Diferencial , Endoscopia , Seio Etmoidal/patologia , Seio Etmoidal/cirurgia , Feminino , Hemangiopericitoma/patologia , Hemangiopericitoma/cirurgia , Humanos , Imuno-Histoquímica , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/cirurgia , Seio Esfenoidal/patologia , Seio Esfenoidal/cirurgia , Tomografia Computadorizada por Raios X
10.
J Craniofac Surg ; 31(8): e778-e781, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33136910

RESUMO

PURPOSE: Sinonasal inverted papilloma (IP) is a benign but locally aggressive tumor for which an endoscopic or external surgical approach is the treatment of choice. Complete resection of IP involving the frontal sinus/recess forms one of the most challenging procedures in the field of sinonasal surgery. This study aims to present our experience in the management of extensive frontal sinus IP based on the attachment sites of the tumor. METHODS: Thirteen patients with IP involving the frontal sinus/recess between 2010 and 2018 were presented. The data collected include demographic data, tumor attachment sites, tumor extension, tumor staging according to Meng's staging system, surgical approach, recurrence, and follow-up. RESULTS: The patients were successfully treated by endoscopic surgery without any additional external approaches. The attachment sites of the IP were multifocal in some patients. No recurrence was identified after an average follow-up period of 52.88 months. No major intra- or postoperative complications were observed. CONCLUSION: The present study shows that attachment-oriented excision for IP involving the frontal sinus/recess is an acceptable approach. Surgeons should select the surgical approach based on the attachment sites of the tumor rather than the extension of the tumor. Even more importantly, the tumor attachment sites should include the sites of adhesion to the bone wall and the site of origin.


Assuntos
Seio Frontal/cirurgia , Papiloma Invertido/cirurgia , Neoplasias dos Seios Paranasais/cirurgia , Adulto , Idoso , Endoscopia , Seio Frontal/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Papiloma Invertido/diagnóstico por imagem , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/patologia , Complicações Pós-Operatórias , Estudos Retrospectivos
11.
Hum Pathol ; 104: 105-116, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32818509

RESUMO

SMARCB1-deficient sinonasal carcinoma (SNC) is an aggressive malignancy characterized by INI1 loss mostly owing to homozygous SMARCB1 deletion. With the exception of a few reported cases, these tumors have not been thoroughly studied by massive parallel sequencing (MPS). A retrospective cohort of 22 SMARCB1-deficient SNCs were studied by light microscopy, immunohistochemistry, fluorescence in situ hybridization (n = 9), targeted exome MPS (n = 12), and Fraction and Allele-Specific Copy Number Estimates from Tumor Sequencing (FACETS) (n = 10), a bioinformatics pipeline for copy number/zygosity assessment. SMARCB1-deficient SNC was found in 13 (59%) men and 9 (41%) women. Most common growth patterns were the basaloid pattern (59%), occurring mostly in men (77%), and plasmacytoid/eosinophilic/rhabdoid pattern (23%), arising mostly in women (80%). The former group was significantly younger (median age = 46 years, range = 24-54, vs 79 years, range = 66-95, p < 0.0001). Clear cell, pseudoglandular, glandular, spindle cell, and sarcomatoid features were variably present. SMARCB1-deficient SNC expressed cytokeratin (100%), p63 (72%), neuroendocrine markers (52%), CDX-2 (44%), S-100 (25%), CEA (4/4 cases), Hepatocyte (2/2 cases), and aberrant nuclear ß-catenin (1/1 case). SMARCB1 showed homozygous deletion (68%), hemizygous deletion (16%), or truncating mutations associated with copy neutral loss of heterozygosity (11%). Coexisting genetic alterations were 22q loss including loss of NF2 and CHEK2 (50%), chromosome 7 gain (25%), and TP53 V157F, CDKN2A W110∗, and CTNNB1 S45F mutations. At 2 years and 5 years, the disease-specific survival and disease-free survival were 70% and 35% and 13% and 0%, respectively. SMARCB1-deficient SNCs are phenotypically and genetically diverse, and these distinctions warrant further investigation for their biological and clinical significance.


Assuntos
Biomarcadores Tumorais/genética , Heterogeneidade Genética , Neoplasias Nasais/genética , Neoplasias dos Seios Paranasais/genética , Proteína SMARCB1/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/deficiência , Intervalo Livre de Doença , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Estadiamento de Neoplasias , Neoplasias Nasais/química , Neoplasias Nasais/patologia , Neoplasias Nasais/terapia , Neoplasias dos Seios Paranasais/química , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/terapia , Fenótipo , Estudos Retrospectivos , Proteína SMARCB1/deficiência , Fatores de Tempo , Adulto Jovem
12.
Ann Afr Med ; 19(3): 191-197, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32820732

RESUMO

Background: Sinonasal neoplasia comprises approximately 3% of all head-and-neck tumors. However, the incidence of these tumors may be greater in some parts of the world including Asia and Africa. Aim and Objective: The study aimed to review the clinical and histopathological pattern of sinonasal neoplasms in Kano, Nigeria. Materials and Methods: The records of patients managed for sinonasal neoplasia at the Department of Otorhinolaryngology, Aminu Kano Teaching Hospital, Kano, Nigeria, over a period of 10 years were reviewed. Information obtained from the case files included demographic characteristics, tumor characteristics, and clinical information. The data obtained were analyzed using SPSS version 23. Results: A total of 245 patients were reviewed with sinonasal neoplasms. Among these, 168 (68.57%) were males, with a sex ratio (M:F) of 2.18:1. The mean age was 40.2 ± 18.9 years. Malignant sinonasal neoplasm constituted 55.92%% of the sinonasal neoplasia, with peak age at the fifth decade. Squamous cell carcinoma was the most common histological subtypes seen in 50.36% of the patients. Inverted papilloma was the most common benign sinonasal neoplasia (42.59%). The most common symptom presented by the patients was nasal obstruction (77.55%), mostly presented within 6 months of onset of symptoms (63.67%), and farmers were the predominant (27.76%). The most common treatment modality was surgical extirpation (54%), and most of the patients presented with Stage IV disease (88%). The site of tumor was found to statistically correlate with the type of tumor among the patients (P ≤ 0.0001), whereas the type of tumor and site of tumor correlated significantly with the duration of symptoms before the presentation. Conclusion: Malignant sinonasal disease is the predominant sinonasal neoplasm in this environment, and most of the patients presented with advanced disease.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Epistaxe/etiologia , Obstrução Nasal/etiologia , Neoplasias dos Seios Paranasais/cirurgia , Seios Paranasais/patologia , Adolescente , Adulto , Idoso , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/patologia , Feminino , Hospitais de Ensino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Neoplasias dos Seios Paranasais/epidemiologia , Neoplasias dos Seios Paranasais/patologia , Estudos Retrospectivos , Adulto Jovem
13.
Head Neck ; 42(11): 3316-3325, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32737953

RESUMO

BACKGROUND: Sinonasal mucosal melanoma (SNMM) is an aggressive cancer with high mortality. Identifying patients at risk of distant metastasis assists with management and prognostication. We aimed to define the relationship between volume, survival, and risk of distant metastases. METHODS: A retrospective review of all patients with SNMM treated at a single institution over a 21-year period was conducted. Tumor volume was calculated using cross-sectional imaging and survival analysis was performed. RESULTS: Sixty-one patients were included. Tumor volume was predictive of local progression-free survival (P = .03), distant metastases-free survival (DMFS) (P = .002), and overall survival (OS) (P = .02). It was a better predictor than AJCC stage and T-classification. Tumor volume equal to or greater than 5 cm3 was associated with a significantly worse DMFS and OS (P = .02 and .009, respectively). CONCLUSION: Calculation of tumor volume assists in quantifying the risk of distant metastases and death in SNMM.


Assuntos
Melanoma , Neoplasias dos Seios Paranasais , Humanos , Melanoma/patologia , Mucosa Nasal/patologia , Estadiamento de Neoplasias , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/terapia , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Carga Tumoral
15.
Adv Otorhinolaryngol ; 84: 168-184, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32731236

RESUMO

Sinonasal malignancies are uncommon, representing 1% of all neoplasms. A wide spectrum of malignant neoplasms arise from the sinonasal and skull base regions; the majority of these tumors are poorly or undifferentiated tumors manifesting overlapping features that result in diagnostic challenges. Sinonasal neuroendocrine carcinoma (SNEC) and sinonasal undifferentiated carcinoma (SNUC) are types of sinonasal neuroendocrine tumor, together with olfactory neuroblastoma. They share overlapping clinical, radiological, and histopathological features, albeit with variability in behavior and prognosis between each other. The literature is at variance regarding the appropriate management strategy of these tumors due to their rarity and difficulty in establishing the correct diagnosis. In recent years progress has been made in the diagnostic techniques and treatment strategies implemented for these tumors. Here we provide a comprehensive review of the recent literature, focusing on the recent advances in histopathological and ancillary diagnosis, and different treatment options for SNEC and SNUC.


Assuntos
Carcinoma Neuroendócrino/patologia , Carcinoma/patologia , Neoplasias do Seio Maxilar/patologia , Neoplasias dos Seios Paranasais/patologia , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , Neuroblastoma/patologia
16.
Adv Otorhinolaryngol ; 84: 197-209, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32731238

RESUMO

Sinonasal adenoid cystic carcinoma is a rare malignancy characterized by an insidious growth pattern and a tendency for perineural spread along major and minor nerves, resulting in invasion of the skull base and intracranial extension. Therefore, many patients present with advanced disease and involvement of critical structures, making treatment difficult and potentially associated with high morbidity. Surgery represents the mainstay of treatment of the primary tumor. Complete resection of the tumor with negative margins, whenever feasible, is associated with better survival outcomes. However, in the case of extensive involvement of vital structures (e.g., carotid artery, cavernous sinus, optic nerve, Meckel's cave) or when radical surgery could seriously affect the patient's quality of life, a function-preserving subtotal removal of the tumor followed by irradiation can be proposed. The role of surgery is limited to a biopsy in unresectable lesions that are more suitable for non-surgical treatments (e.g., exclusive chemoradiation). Given the difficulty in obtaining negative margins and the propensity for submucosal and perineural spread, adjuvant radiotherapy is strongly recommended. Recently, heavy-particle radiotherapy using protons or carbon ions has emerged as a promising treatment with improved local control. Local failures (60%) and distant metastases (40%) are common and can occur even decades after definitive treatment. The 5-year overall survival ranges from 55 to 70% and it exceeds that of other sinonasal malignancies, but dramatically drops down at 10 years (40%) and further decreases at 20 years (15%). Therefore, a prolonged follow-up of at least 15 years, and possibly lifelong, is mandatory.


Assuntos
Carcinoma Adenoide Cístico , Neoplasias dos Seios Paranasais , Neoplasias das Glândulas Salivares , Adulto , Carcinoma Adenoide Cístico/diagnóstico , Carcinoma Adenoide Cístico/patologia , Carcinoma Adenoide Cístico/radioterapia , Carcinoma Adenoide Cístico/cirurgia , Feminino , Cabeça/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/radioterapia , Neoplasias dos Seios Paranasais/cirurgia , Seios Paranasais/diagnóstico por imagem , Radioterapia Adjuvante , Neoplasias das Glândulas Salivares/diagnóstico , Neoplasias das Glândulas Salivares/patologia , Neoplasias das Glândulas Salivares/radioterapia , Neoplasias das Glândulas Salivares/cirurgia , Glândulas Salivares/diagnóstico por imagem
17.
J Cancer Res Ther ; 16(3): 686-689, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32719293

RESUMO

Central nervous damage related to intra-arterial infusion chemotherapy (IAC) for head and neck cancer reported to date are cerebral infarction, transient ischemic attack, and neuropathy. There have been no reports of cerebral hemorrhage as an IAC-related complication for head and neck cancer. Authors report a case that underwent intra-arterial infusion chemoradiotherapy for advanced sphenoid sinus cancer which extended to the left cavernous sinus and cranium, subsequently suffered cerebral hemorrhage thought to have been caused by IAC. Treatment should be performed with greater caution when the head and neck cancer involves the cavernous sinus or cranium, as in the present case.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Hemorragia Cerebral/etiologia , Neoplasias dos Seios Paranasais/tratamento farmacológico , Seio Esfenoidal/patologia , Idoso , Hemorragia Cerebral/induzido quimicamente , Hemorragia Cerebral/patologia , Quimiorradioterapia , Docetaxel/administração & dosagem , Feminino , Humanos , Infusões Intra-Arteriais , Compostos Organoplatínicos/administração & dosagem , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/radioterapia , Prognóstico
19.
BMJ Case Rep ; 13(7)2020 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-32624487

RESUMO

Sinonasal inverted schneiderian papilloma (ISP) is a rare tumour, which almost exclusively arises from the mucosa lining, the nasal cavity and the paranasal sinuses. The tumour in its early stages presents as an asymptomatic mass, which may be discovered during routine examination. Large lesions usually measure a few millimetres to centimetres in size and show symptoms such as nasal blockade, recurrent sinusitis, postnasal drip, anosmia, epistaxis, facial pain and headache. Lesion presenting as a large oral mass is extremely rare and may cause diagnostic dilemma, resulting in misdiagnosis. This report describes a rare case of ISP presenting as large intraoral lesion, with wide area of facial skeletal involvement. Diagnosis and management of the pathology has also been highlighted.


Assuntos
Mucosa Bucal/patologia , Papiloma Invertido/patologia , Neoplasias dos Seios Paranasais/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Papiloma Invertido/diagnóstico por imagem , Papiloma Invertido/cirurgia , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/cirurgia
20.
Neuroradiology ; 62(9): 1149-1155, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32562035

RESUMO

PURPOSE: To evaluate whether imaging features on conventional magnetic resonance imaging (MRI) can differentiate sinonasal extranodal natural killer/T cell lymphomas (ENKTL) from diffuse large B cell lymphoma (DLBCL). METHODS: Consecutively, pathology-proven 59 patients with ENKTL and 27 patients with DLBCL in the sinonasal region were included in this study. Imaging features included tumor side, location, margin, pre-contrast T1 and T2 signal intensity and homogeneity, post-contrast enhancement degree and homogeneity, septal enhancement pattern, internal necrosis, mass effect, and adjacent involvements. These imaging features for each ENKTL or DLBCL on total 86 MRI scans were indicated independently by two experienced head and neck radiologists. The MRI-based performance in differential diagnosis of the two types of lymphomas was evaluated by multivariate logistic regression analysis. RESULTS: All ENKTLs were located in the nasal cavity, with ill-defined margin, heterogeneous signal intensity, internal necrosis, marked enhancement of solid component on MRI, whereas DLBCLs were more often located in the paranasal sinuses, with MR homogenous intensity, mild enhancement, septal enhancement pattern, and intracranial or orbital involvements (all P < 0.05). Using a combination of location, internal necrosis and septal enhancement pattern of the tumor in multivariate logistic regression analysis, sensitivity, specificity, and accuracy in differential diagnosis of ENKTL and DLBCL were 100%, 79.4%, and 91.9%, respectively, for radiologist 1, and were 98.3%, 81.5%, and 93.0%, respectively, for radiologist 2. CONCLUSION: MRI can effectively differentiate ENKTL from DLBCL in the sinonasal region with a high diagnostic accuracy.


Assuntos
Linfoma Extranodal de Células T-NK/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Idoso , Meios de Contraste , Diagnóstico Diferencial , Feminino , Humanos , Linfoma Extranodal de Células T-NK/patologia , Linfoma Difuso de Grandes Células B/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias dos Seios Paranasais/patologia , Estudos Retrospectivos , Sensibilidade e Especificidade
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...