Lymph Node Metastases in Malignant Tumors of the Paranasal Sinuses

Cantù, Giulio; Bimbi, Gabriella; Miceli, Rosalba; Mariani, Luigi; Colombo, Sarah; Riccio, Stefano; Squadrelli, Massimo; Battisti, A; Pompilio, Madia; Rossi, Marco

doi:10.1001/archoto.2007.30

Cited by 142 publications

(128 citation statements)

References 26 publications

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“…p16 overexpression was seen in all of our cases (luminal nuclear and cytoplasmic reaction; stronger cytoplasmic reaction than in those cases that had associated pleomorphic adenoma), but does not necessarily imply biologically integrated HPV as a potential etiology, as it does with oropharyngeal carcinoma [12]. None of the cases tested contained high-risk HPV (which includes 16,18,31,33,35,39,45,51,52,56,58, and 66) by in situ hybridization, different from a recent series reporting the presence of HPV 33 specifically [141].…”

Section: Immunohistochemical Studiesmentioning

confidence: 59%

Sinonasal Tract and Nasopharyngeal Adenoid Cystic Carcinoma: A Clinicopathologic and Immunophenotypic Study of 86 Cases

Thompson

Penner

Ho³

et al. 2013

Head and Neck Pathol

119

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'Primary sinonasal tract and nasopharyngeal adenoid cystic carcinomas (STACC) are uncommon tumors that are frequently misclassified, resulting in inappropriate clinical management. Eighty-six cases of STACC included 45 females and 41 males, aged 12-91 years (mean 54.4 years). Patients presented most frequently with obstructive symptoms (n = 54), followed by epistaxis (n = 23), auditory symptoms (n = 12), nerve symptoms (n = 11), nasal discharge (n = 11), and/or visual symptoms (n = 10), present for a mean of 18.2 months. The tumors involved the nasal cavity alone (n = 25), nasopharynx alone (n = 13), maxillary sinus alone (n = 4), or a combination of the nasal cavity and paranasal sinuses (n = 44), with a mean size of 3.7 cm. Patients presented equally between low and high stage disease: stage I and II (n = 42) or stage III and IV (n = 44) disease. Histologically, the tumors were invasive (bone: n = 66; neural: n = 47; lymphovascular: n = 33), composed of a variety of growth patterns, including cribriform (n = 33), tubular (n = 16), and solid (n = 9), although frequently a combination of these patterns was seen within a single tumor. Pleomorphism was mild with an intermediate N:C ratio in cells containing hyperchromatic nuclei. Reduplicated basement membrane and glycosaminoglycan material was commonly seen. Necrosis (n = 16) and atypical mitotic figures (n = 11) were infrequently present. Pleomorphic adenoma was present in 9 cases; de-differentiation was seen in two patients. Immunohistochemical studies showed positive reactions for pan-cytokeratin, CK7, CK5/6, CAM5.2, and EMA, with myoepithelial reactivity with SMA, p63, calponin, S100 protein and SMMHC. CD117, CEA, GFAP and p16 were variably present. CK20 and HR HPV were negative. STACC needs to be considered in the differential diagnosis of most sinonasal malignancies, particularly poorly differentiated carcinoma, olfactory neuroblastoma and pleomorphic adenoma. Surgery (n = 82), often accompanied by radiation therapy (n = 36), was generally employed. A majority of patients developed a recurrence (n = 52) 2-144 months after initial presentation. Overall mean follow-up was 19.4 years (range 0.4-37.5 years): 46 patients died with disease (mean 6.4 years); 5 were alive with disease (mean 5.4 years), and 35 patients were either alive or had died of unrelated causes (mean 16.3 years). ACC of the SNT is uncommon. Recurrences are common. The following parameters, when present, suggest an increased incidence of either recurrence or dying with disease: mixed site of involvement, high stage disease (stage IV), skull base involvement, tumor 123Head and Neck ) 8:88-109 DOI 10.1007 recurrence, a solid histology, perineural invasion, bone invasion, and lymphovascular invasion.

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Section: Immunohistochemical Studiesmentioning

confidence: 59%

Sinonasal Tract and Nasopharyngeal Adenoid Cystic Carcinoma: A Clinicopathologic and Immunophenotypic Study of 86 Cases

Thompson

Penner

Ho³

et al. 2013

Head and Neck Pathol

119

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“…Regarding the correlation between local extension site and neck lymph node metastasis at diagnosis, the nasopharynx and hard palate were both correlated with lymph node metastasis. There was a report that the rate of neck metastasis is much higher in T2 tumors than in T3 or T4 tumors 10 . The reason for this was suspected to be that cases with extension to the hard palate diagnosed as T2 are more likely to develop lymph node metastasis.…”

Section: Discussionmentioning

confidence: 97%

Lymph Node Metastasis in T4 Maxillary Sinus Squamous Cell Carcinoma: Incidence and Treatment Outcome

et al. 2014

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SYNOPSISThis study identified the incidence of lymph node metastasis among patients with T4 maxillary sinus squamous cell carcinoma (MS-SCC) as well as the delayed metastasis rate and the treatment outcome for untreated N0 neck in patients with T4 MS-SCC. 5 ABSTRACT PURPOSETo evaluate the incidence of lymph node metastasis among patients with T4 maxillary sinus squamous cell carcinoma (MS-SCC) as well as the delayed metastasis rate and the treatment outcome for untreated N0 neck in patients with T4 MS-SCC. PATIENTS AND METHODSConsecutive series of all patients (n=128) with previously untreated T4 maxillary sinus RESULTSTwenty-eight (21.9%) of the 128 patients had lymph node metastasis, and 6 patients (4.7%) had distant metastasis at diagnosis. Among the 111 patients who were treated with curative intent, 98 had clinically N0 neck disease and did not receive prophylactic neck irradiation. A total of 11 patients (11.2%) subsequently developed evidence of lymph node metastasis, of whom 8 were among the 83 patients with an N0 neck and had not received elective neck treatment. There were 15 patients who received an elective neck dissection as part of the initial treatment, of whom 3 had pathologically positive for lymph node metastases. Of 11 patients, 6 patients with non-lateral retropharyngeal 6 lymph node metastasis without primary or distant disease were successfully salvaged. CONCLUSIONThis study identified the incidence of lymph node metastasis among patients with T4MS-SCC as well as the delayed metastasis rate and the treatment outcome for untreated N0 neck in patients with T4 MS-SCC. These results will be of assistance in selecting treatment strategy for T4 MS-SCC in the future. Maxillary sinus cancer is the most common form is sinonasal cancer. But the incidence of it has been considered to be decreasing gradually. According to vital statistics obtained from the Ministry of Health, Labour and Welfare, Japan, the number of deaths due to the maxillary sinus cancer was 1, 051, 643, and 175, in 1971, 1991, and 2011, respectively. Some investigators in Japan consider this decrease to be correlated with the decrease in sinusitis, which is considered to be one of the risk factors of maxillary sinus cancer.The Japanese head and neck community has been gaining experience in the treatment of patients with maxillary sinus cancer due to the many opportunities we have to treat them, and most head and neck surgeons and radiation oncologists in Japan prefer to take a common sense "wait-and-see" approach in the management of patients with clinically negative neck as the incidence of delayed neck metastasis is considered to be low. However, whether clinically negative neck in patients with the maxillary sinus cancer should be irradiated prophylactically or not is controversial in Europe and the United States 1, 2 .In addition, the incidence of neck metastasis in cases of maxillary sinus cancer has not been well defined, although it is currently believed to be low. To help clarify the situation, a multi-institutional join...

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“…Prophylactic treatment of cervical node for patients with stage N0 is controversial. 21,44,45 The incidence of delayed cervical metastases has been assessed as being 17% to 33%, 12,17,19,44 whereas only 5% of patients are initially seen with nodes to be treated by neck dissection or radiotherapy. 12 This had led some authors to consider elective nodal radiotherapy in selected patients.…”

Section: Discussionmentioning

confidence: 99%