Clinicopathological Analysis of Undifferentiated Malignant Neoplasms of the Sinonasal tract
Keywords:
Undifferentiated, Malignant, Sinonasal, Neoplasms, Immunohistochemistry
Abstract
Background: Sinonasal tumours are characterized by low incidence, non specific symptoms, and late presentation. Aggressive, non–squamous cell epithelial and nonepithelial malignant neoplasms of varying histogenesis occurring in sinonasal region are grouped under the term undifferentiated malignant neoplasms. Frequently, these undifferentiated malignancies share clinical and light microscopic features, which make differentiation of one from the other virtually impossible without the use of adjunct immunohistochemical analysis . Methods: Undifferentiated malignant sinonasal tumors biopsied or surgically excised over a period of 5 years were studied.Result: We encountered 22 cases of undifferentiated malignant sinonasal tumors with an incidence of 0.05%, with a mean age of 41 to 50 years and the male to female ratio was 2.1:1. Epithelial tumors (18 cases) constituting 81.82 % predominated over non epithelial tumors (4 cases) constituting 18.18% with a ratio of 4.5:1. 16 tumors involved the nasal cavity (72.7%) and 6 involved paranasal sinuses (27.3%). The most common clinical presentation was mass in the nose 19 cases (86.36%). The most common Undifferentiated malignant tumor encountered was Sinonasal undifferentiated carcinoma-10 cases (45.45%).Conclusion: A variety of undifferentiated malignant neoplasms occur in the sinonasal tract with overlapping clinical and pathologic findings. In limited biopsy material, differentiation of these tumor types can be challenging and differentiating these tumors with the help of immunohistoochemistry has clinical importance because advances in therapeutic intervention may increase survival with good quality of life, and in some instances may achieve a cure. DOI: 10.21276/APALM.1417References
1. Wenig BM, Pilch BZ. Tumours of upper respiratory tract. In: Fletcher Christopher DM, editor. Diagnostic Histopathology of Tumours.2nded.Vol.1: London: Harcourt publishersLtd; 2000. 87-138.
2. Taxy JB. Upper respiratory tract. In: Damjanor I, Linder J, editors.Anderson’s Pathology.10th ed.Vol .1; Missouri: Mosby Year Book; 1996. 1446-1469.
3. Barnes L, Eveson John W, Peter R, Sidransky D. Pathology and Genetics-Head and Neck Tumours.World health Organisation classification Of Tumours. Lyon:IARC Press:2005.9-82, 284.
4. Chukuezi AB, Nwosu JN. Pattern of Nasal and Paranasal sinus tumours in Owerri ,Nigeria. Research Journal of Medical Sciences. 2010; 4:11-14.
5. Panchal L, Vaideeswar P, Kathpal D, Madiwale CV, Prabhat DP. Sino-nasal epithelial tumours: A pathological study of 69 cases. J Postgrad Med .2005; 51:30-5.
6. De Paula Araujo R, Gomes EF, de Menezes DB. Rare sinonasal tumors: Case series and literature review. Braz J Otorhinolaryngol. 2008; 74:307-14.
7. Khan N, Zafar U, Afroz N, Ahmad SS, Hasan SA. Masses of nasal cavity,paranasal sinuses:A clinicopathologic study. Indian journal of otolaryngology and head and neck surgery 2006; 58:259-63.
8. Casiraghi O, Lefèvre M. Undifferentiated malignant round cell tumors of the sinonasal tract and nasopharynx. Ann Pathol. 2009 Sep; 29:296-312.
9. Wenig BM. Undifferentiated malignant neoplasms of the sinonasal tract. Arch Pathol Lab Med. 2009 May; 133:699-712.
10.Ejaz A, Wenig BM. Review Sinonasal undifferentiated carcinoma: clinical and pathologic features and a discussion on classification, cellular differentiation, and differential diagnosis. Adv Anat Pathol. 2005; 12:134-43.
11. López F, Rodrigo JP, Cardesa A. Update on primary head and neck mucosal melanoma. Head & neck. 2016; 38:147-155.
12. Clifton N, Harrison L, Bradley P J, Jones N S. Malignant melanoma of nasal cavity and paranasal sinuses: report of 24 patients and literature review. Journal of Laryngology and Otology.2011; 125:479–485.
13. Thompson LDR, Wieneke JA, Miettinen M. Sinonasal Tract and Nasopharyngeal Melanomas.A Clinicopathologic Study of 115 Cases With a ProposedStaging System. The American Journal of Surgical Pathology. 2003;27: 594–611.
14. Kawabata M, Yoshifuku K, Sagara Y, Kurono Y.Ewing's sarcoma/primitive neuroectodermal tumour occurring in the maxillary sinus. Rhinology. 2008; 46:75-8.
15. Shah K, Perez-Ordóñez B.Neuroendocrine Neoplasms of the Sinonasal Tract: Neuroendocrine Carcinomas and Olfactory Neuroblastoma. Head Neck Pathol. 2016; 10:85-94.
16. Bragg, Taryn McFadden, Scianna, Joseph , Kassam, Amin, Emami, Bahman. Clinicopathological review: esthesioneuroblastoma. Neurosurgery. 2009; 64:764-770.
17. Theilgaard SA, Buchwald C, Ingeholm P, Larsen SK, Eriksen J: Esthesioneuroblastoma: a Danish demographic study of 40 patients registered between 1978 and 2000. Acta Otolaryngol. 2003; 123:433-9.
18. Dulguerov P, Allal AS, Calcaterra TC. Esthesioneuroblastoma: a metaanalysis and review. Lancet Oncol 2001; 2:683-90.
19. Menon S, Pai P, Sengar M, Aggarwal JP, Kane SV.Sinonasal malignancies with neuroendocrine differentiation: case series and review of literature. Indian J Pathol Microbiol. 2010; 53:28-34.
20. Rischin D, Coleman A. Sinonasal Malignancies of Neuroendocrine Origin. Hematol Oncol Clin N Am. 2008; 22:1297-316.
21. Babin E, Rouleau V, Vedrine PO, Toussaint B, de Raucourt D.Small cell neuroendocrine carcinoma of the nasal cavity and paranasal sinuses. J Laryngol Otol. 2006; 120:289-97.
2. Taxy JB. Upper respiratory tract. In: Damjanor I, Linder J, editors.Anderson’s Pathology.10th ed.Vol .1; Missouri: Mosby Year Book; 1996. 1446-1469.
3. Barnes L, Eveson John W, Peter R, Sidransky D. Pathology and Genetics-Head and Neck Tumours.World health Organisation classification Of Tumours. Lyon:IARC Press:2005.9-82, 284.
4. Chukuezi AB, Nwosu JN. Pattern of Nasal and Paranasal sinus tumours in Owerri ,Nigeria. Research Journal of Medical Sciences. 2010; 4:11-14.
5. Panchal L, Vaideeswar P, Kathpal D, Madiwale CV, Prabhat DP. Sino-nasal epithelial tumours: A pathological study of 69 cases. J Postgrad Med .2005; 51:30-5.
6. De Paula Araujo R, Gomes EF, de Menezes DB. Rare sinonasal tumors: Case series and literature review. Braz J Otorhinolaryngol. 2008; 74:307-14.
7. Khan N, Zafar U, Afroz N, Ahmad SS, Hasan SA. Masses of nasal cavity,paranasal sinuses:A clinicopathologic study. Indian journal of otolaryngology and head and neck surgery 2006; 58:259-63.
8. Casiraghi O, Lefèvre M. Undifferentiated malignant round cell tumors of the sinonasal tract and nasopharynx. Ann Pathol. 2009 Sep; 29:296-312.
9. Wenig BM. Undifferentiated malignant neoplasms of the sinonasal tract. Arch Pathol Lab Med. 2009 May; 133:699-712.
10.Ejaz A, Wenig BM. Review Sinonasal undifferentiated carcinoma: clinical and pathologic features and a discussion on classification, cellular differentiation, and differential diagnosis. Adv Anat Pathol. 2005; 12:134-43.
11. López F, Rodrigo JP, Cardesa A. Update on primary head and neck mucosal melanoma. Head & neck. 2016; 38:147-155.
12. Clifton N, Harrison L, Bradley P J, Jones N S. Malignant melanoma of nasal cavity and paranasal sinuses: report of 24 patients and literature review. Journal of Laryngology and Otology.2011; 125:479–485.
13. Thompson LDR, Wieneke JA, Miettinen M. Sinonasal Tract and Nasopharyngeal Melanomas.A Clinicopathologic Study of 115 Cases With a ProposedStaging System. The American Journal of Surgical Pathology. 2003;27: 594–611.
14. Kawabata M, Yoshifuku K, Sagara Y, Kurono Y.Ewing's sarcoma/primitive neuroectodermal tumour occurring in the maxillary sinus. Rhinology. 2008; 46:75-8.
15. Shah K, Perez-Ordóñez B.Neuroendocrine Neoplasms of the Sinonasal Tract: Neuroendocrine Carcinomas and Olfactory Neuroblastoma. Head Neck Pathol. 2016; 10:85-94.
16. Bragg, Taryn McFadden, Scianna, Joseph , Kassam, Amin, Emami, Bahman. Clinicopathological review: esthesioneuroblastoma. Neurosurgery. 2009; 64:764-770.
17. Theilgaard SA, Buchwald C, Ingeholm P, Larsen SK, Eriksen J: Esthesioneuroblastoma: a Danish demographic study of 40 patients registered between 1978 and 2000. Acta Otolaryngol. 2003; 123:433-9.
18. Dulguerov P, Allal AS, Calcaterra TC. Esthesioneuroblastoma: a metaanalysis and review. Lancet Oncol 2001; 2:683-90.
19. Menon S, Pai P, Sengar M, Aggarwal JP, Kane SV.Sinonasal malignancies with neuroendocrine differentiation: case series and review of literature. Indian J Pathol Microbiol. 2010; 53:28-34.
20. Rischin D, Coleman A. Sinonasal Malignancies of Neuroendocrine Origin. Hematol Oncol Clin N Am. 2008; 22:1297-316.
21. Babin E, Rouleau V, Vedrine PO, Toussaint B, de Raucourt D.Small cell neuroendocrine carcinoma of the nasal cavity and paranasal sinuses. J Laryngol Otol. 2006; 120:289-97.
Published
2017-08-31
Issue
Section
Original Article
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
