Coexistence of a Nasal Mucoepidermoid Carcinoma and Sphenoid Mucoceles

Bt, Schaeffer; Pm, Som; Sacher, Michael; Cf, Lanzieri; Solodnik, Paul; Lawson, William; Hf, Biller

doi:10.1097/00004728-198507010-00028

Cited by 6 publications

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“…A review of publications in English (MEDLINE, 1966-2011) was performed, with all cases reported as MEC of the sinonasal tract included in the review [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. However, many cases were excluded if the lesion arose primarily in the oral cavity or parotid gland and extended into the sinonasal tract, or represented a different tumor type (hamartoma, squamous cell carcinoma, primary sinonasal tract adenocarcinoma), or if the information was too generalized and non-specific to make a meaningful interpretation of the demographics, histologic features, or patient outcome [8,9,11,13,[32][33][34][35][36][37][38][39][40][41].…”

Section: Methodsmentioning

confidence: 99%

“…The varied clinical behavior, treatment alternatives, and long-term patient prognosis of the different grades of MEC play a role in diagnosis and management for major salivary gland sites. While there have been a few series, the information is often included with general discussions about carcinoma of the sinonasal tract, about MEC in the head and neck [6][7][8][9][10][11][12][13][14][15], or is limited to case reports in the English literature (Table 2) [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Therefore, there is no large comprehensive evaluation of primary sinonasal tract MECs with respect to their histomorphology, immunohistochemical reactivity, clinical behavior, and treatment outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…Review of the English literature on sinonasal tract mucoepidermoid carcinoma[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] …”

mentioning

confidence: 99%

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Sinonasal Tract Mucoepidermoid Carcinoma: A Clinicopathologic and Immunophenotypic Study of 19 Cases Combined with a Comprehensive Review of the Literature

Wolfish

Nelson

Thompson

2011

Head and Neck Pathol

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Primary sinonasal tract mucoepidermoid carcinomas (MEC) are uncommon tumors that are frequently misclassified, resulting in inappropriate clinical management. The design of this study is retrospective. Nineteen cases of MEC included 10 females and 9 males, aged 15-75 years (mean, 52.7 years); males, on average were younger by a decade than females (47.2 vs. 57.7 years). Patients presented most frequently with a mass, obstructive symptoms, pain, and/or epistaxis present for a mean of 12.6 months. The majority of tumors involved the nasal cavity alone (n=10), maxillary sinus alone (n=6), or a combination of the nasal cavity and paranasal sinuses (n=3) with a mean size of 2.4 cm. Most patients presented at a low clinical stage (n=15, Stage I & II), with only 4 patients presenting with Stage III disease. Histologically, the tumors were often invasive (bone or perineural invasion), with invasion into minor mucoserous glands. Surface involvement was common. The neoplastic cells were composed of a combination of squamoid cells, intermediate cells, and mucocytes. Cystic spaces were occasionally large, but the majority were focal to small. Pleomorphism was generally low grade. Necrosis (n=5) and atypical mitotic figures (n=6) were seen infrequently. Over half of the tumors were classified as low grade (n=11), with intermediate (n=4) and high grade (n=4) comprising the remainder. Mucicarmine was positive in all cases tested. Immunohistochemical studies showed positive reactions for keratin, CK5/6, p63, CK7, EMA, and CEA in all cases tested, while bcl-2 and CD117 were rarely positive. GFAP, MSA, TTF-1, and S100 protein were non-reactive. p53 and Ki-67 were reactive to a variable degree. MEC need to be considered in the differential diagnosis of a number of sinonasal lesions, particularly adenocarcinoma and necrotizing sialometaplasia. The patients were separated into stage I (n=9), stage II (n=6), and stage III (n=4), without any patients in stage IV at presentation. Surgery occasionally accompanied by radiation therapy (n=2) was generally employed. Six patients developed a recurrence, with 5 patients dying with disease (mean, 2.4 years), while 14 patients are either alive (n=9) or had died (n=5) of unrelated causes (mean, 14.6 years). MEC probably arises from the minor mucoserous glands of the upper aerodigestive tract, usually presenting in patients in middle age with a mass. Most patients present with low stage disease (stage I and II), although invasive growth is common. Recurrences develop in about a third of patients, who experience a shorter survival (mean, 6.5 years). The following parameters, when present, suggest an increased incidence of recurrence or dying with disease: size ≥ 4.0 cm (P=0.034), high mitotic count (P=0.041), atypical mitoses (P=0.007), mixed anatomic site (P=0.032), development of recurrence (P=0.041), high tumor grade (P=0.007), and higher stage disease (P=0.027).

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sinonasal Tract Mucoepidermoid Carcinoma: A Clinicopathologic and Immunophenotypic Study of 19 Cases Combined with a Comprehensive Review of the Literature

Wolfish

Nelson

Thompson

2011

Head and Neck Pathol

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“…11 The association of a sphenoid mucocele with sino-nasal or nasopharyngeal neoplasms has rarely been addressed in the literature, and only a well-detailed case where a nasal mucoepidermoid carcinoma coexisted with a sphenoid mucocele has been reported. 12 In our patient, the mucocele was secondary to an acinic cell carcinoma of the minor salivary glands.…”

Section: Sphenoid Mucocele Usually Tends To Grow In Anmentioning

confidence: 61%

Sphenoid mucocele with intracranial invasion secondary to nasopharyngeal acinic cell carcinoma

et al. 1991

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We present a case of sphenoid mucocele with large invasion of the middle cranial fossa, secondary to a nasopharyngeal acinic cell carcinoma, occurring in a 52-year-old man. To the best of our knowledge, this association has not been reported so far. We discuss the importance of imaging techniques in delineating the relationship between the two lesions, as long as the clinical and therapeutic problems related both to sphenoid mucocele and acinic cell carcinoma.

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Sinonasal mucoepidermoid carcinoma: a review of the National Cancer Database

Triantafillou

Maina

Kuan

et al. 2019

Int Forum Allergy Rhinol

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BackgroundPrimary sinonasal mucoepidermoid carcinoma (SN‐MEC) is a malignancy arising from seromucinous glands of the nasal cavity and paranasal sinuses. Given its rarity, few large‐scale studies have been performed. In this study we describe the incidence and determinants of survival of patients with SN‐MEC leveraging the National Cancer Database (NCDB).MethodsThis was a retrospective, population‐based cohort study of patients diagnosed with SN‐MEC between 2004 and 2012 within the NCDB. The main outcome measure was overall survival (OS).ResultsA total of 164 patients were identified. The cohort was composed of 47.6% males. Mean age at diagnosis was 59.7 years. The maxillary sinus was the most common primary site, accounting for 45.7% of cases. Eleven percent of patients presented with nodal disease, whereas 2.1% had distant metastases. Stage IV disease was seen in 30.4% of cases. A total of 79.8% of the patients underwent surgery, 61.0% received radiation therapy, and 15.1% had chemotherapy. OS at 1, 2, and 5 years was 83%, 77.0%, and 57%, respectively. On multivariate analysis, Medicaid insurance status (hazard ratio [HR], 7.29; 95% confidence interval [CI], 1.74‐30.57), advanced tumor size (HR, 4.94; 95% CI, 1.19‐20.5), and advanced nodal disease (N1: HR, 9.48; 95% CI, 1.66‐54.23; N2B: HR, 19.3; 95% CI, 1.07‐350.64) were associated with worse OS.ConclusionMucoepidermoid carcinoma is the most common salivary gland malignancy but a rare sinonasal malignancy, with 5‐year survival for SN‐MEC approximating 50%. A significant proportion of patients present with advanced disease. Both socioeconomic factors and tumor characteristics are associated with survival.

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Coexistence of a Nasal Mucoepidermoid Carcinoma and Sphenoid Mucoceles

Cited by 6 publications

References 0 publications

Sinonasal Tract Mucoepidermoid Carcinoma: A Clinicopathologic and Immunophenotypic Study of 19 Cases Combined with a Comprehensive Review of the Literature

Sinonasal Tract Mucoepidermoid Carcinoma: A Clinicopathologic and Immunophenotypic Study of 19 Cases Combined with a Comprehensive Review of the Literature

Sphenoid mucocele with intracranial invasion secondary to nasopharyngeal acinic cell carcinoma

Sinonasal mucoepidermoid carcinoma: a review of the National Cancer Database

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