Oncocytic carcinoma of the maxillary sinus: a rare neoplasm

Abstract

Oncocytic neoplasms are tumors composed of oncocytes (i.e., epithelial cells with a large cytoplasm that is rich in mitochondria). Most cases are benign and originate from the major salivary glands, while the minor salivary glands are rarely involved. Occurrence of oncocytic carcinoma (or malignant oncocytoma) within the sinonasal tract is an unusual event. We report a rare case of maxillary sinus oncocytic carcinoma occurring in a 45-year-old male. Biopsy was consistent with an unspecified salivary gland neoplasm. The patient underwent total maxillectomy through a lateral rhinotomic approach; hard palate reconstruction with temporal myofascial flap was performed. Definitive histology was consistent with oncocytic carcinoma. Due to the local extension of the lesion, postoperative radiotherapy (60 Gy) was delivered. Three years after surgery, the patient is free from disease. A brief analysis of the literature was also accomplished in order to discuss treatment options and prognosis of this unusual neoplasm.

Nonparotid parapharyngeal oncocytoma: A case report and literature review

“…Oncocytic cells have been found in a variety of organ tissues including salivary gland, thyroid gland, parathyroid gland, pulmonary tree, liver, pancreas, pituitary, ovary, adrenal gland, stomach, testicle, fallopian tube, and kidney 15, 29. Because of the many locations in which oncocytomas have been found, they have been variably named: eosinophilic adenoma, oxyphilic granular cell adenoma, oncocytic cell adenoma, Hürthle cell tumor (when found in the thyroid), and oxyphil adenoma (when found in the parathyroid gland) 30.…”

“…It is a tumor usually seen in older persons and with no predilection for either sex 1. They are most commonly found in the superficial lobe of the parotid,1 but have been reported not only in the submandibular gland2 but also in minor salivary gland tissues of the larynx,3–5 oral cavity,6–8 palate,9, 10 base of tongue,11, 12 nasal cavity,13, 14 paranasal sinuses,15, 16 and masseter 17…”

The key radiologic and cytomorphologic features of oncocytic and oncocytoid lesions of the salivary gland

“…Radiologically, OCs are solid with irregular borders and may invade surrounding structures On CT these lesions are iso‐ to hyperdense with heterogenous enhancement on CT . On MRI, they are isointense on T1‐weighted images with increased central T2 signal …”

“…130,131 Radiologically, OCs are solid with irregular borders and may invade surrounding structures 132 On CT these lesions are iso-to hyperdense with heterogenous enhancement on CT. 133 On MRI, they are isointense on T1-weighted images with increased central T2 signal. 132,134,135 Cytologic smears are generally cellular and show crowded groups of large, polygonal cells with abundant granular cytoplasm, sharp contours, round to oval nuclei and even chromatin 136,137 (Figure 14). The cells may be slightly discohesive, leading to smaller groups and some single cells.…”

Oncocytic carcinoma of the parotid gland

“…Radiotherapy is delivered in advanced‐stage cases, with positive or close resection margins, and/or regional metastasis 4, 6, 13, 18–20. Although chemotherapy is used for treating distant metastasis, the relative roles of radiotherapy and chemotherapy in treatment of this disease remain controversial 3, 6, 10, 21, 22…”