Patterns and Incidence of Neural Invasion in Patients With Cancers of the Paranasal Sinuses

Gil, Ziv; Carlson, Diane L.; Gupta, Amar; Lee, Nancy; Hoppe, Bradford S.; Shah, Jatin P.; Kraus, Dennis H.

doi:10.1001/archoto.2008.525

Cited by 83 publications

(75 citation statements)

References 30 publications

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“…Hematoxylin and eosin-stained slides from all 86 cases were reviewed, with a range of 1-37 slides reviewed per [38]. No meaningful separation was achieved by separating perineural from intraneural invasion, and so these groups were combined in this evaluation.…”

Section: Methodsmentioning

confidence: 99%

“…The diameter of nerve involved, whether intraneural or perineural, and whether the nerves involved are within the tumor or distant from the tumor did not seem to alter the outcome. Therefore, any neural invasion is significant, contributing to a worse patient outcome (p \ 0.0001) [6,35,38,143]. It seems that nerve invasion is not related to local invasion or proliferation, and is an independent factor, possibly related to laminin-5 expression [144] or brain-derived neurotrophic factor [60].…”

Section: Anatomic Sitementioning

confidence: 99%

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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: Methodsmentioning

confidence: 99%

Section: Anatomic Sitementioning

confidence: 99%

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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“…1 However, ACC of the paranasal sinuses and skull base represent a pathology with distinct clinical implications. 3 Those tumors are typically diagnosed late, and their proximity to vital structures (e.g., dura, brain, orbit, and central nerves) makes adequate oncological resection less likely. 4 Another characteristic of ACC of the paranasal sinuses is perineural spread, with an incidence of over 50%.…”

Section: Introductionmentioning

confidence: 99%

Adenoid Cystic Carcinoma of the Nasal Cavity and Paranasal Sinuses: A Meta-Analysis

et al. 2014

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Objectives To identify independent predictors of outcome in patients with adenoid cystic carcinoma (ACC) of the paranasal sinuses and skull base. Design Meta-analysis of the literature and data from the International ACC Study Group. Setting University-affiliated medical center. Participants The study group consisted of 520 patients, 99 of them from the international cohort. The median follow-up period was 60 months (range, 32 to 100 months). Main Outcome Measures Overall survival (OS) and disease-specific survival (DSS).Results The 5-year OS and DSS of the entire cohort were 62% and 67%, respectively. The local recurrence rate was 36.6%, and the regional recurrence rate was 7%. Distant

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“…There are inconsistencies in the literature regarding whether intraneural invasion (or invasion of the endoneurium) should be distinguished from PNI [7,9,10,18,19]. In our survey, most participants (60 %) answered ''no'' when asked if they make a distinction between perineural and intraneural invasion in their pathologic reporting of OSCC.…”

Section: Does Not Address Intraneural Invasionmentioning

confidence: 93%

Interobserver Variation Among Pathologists in Evaluating Perineural Invasion for Oral Squamous Cell Carcinoma

Chi

Chen

Katabi³

et al. 2015

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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Patterns and Incidence of Neural Invasion in Patients With Cancers of the Paranasal Sinuses

Abstract: Paranasal carcinomas have high propensity for NI, whereas melanoma and sarcoma rarely invade nerves. Patterns of NI include both perineural and intraneural invasion. Neural invasion is associated with positive margins, maxillary origin, and previous surgery.

Cited by 83 publications

References 30 publications

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

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

Adenoid Cystic Carcinoma of the Nasal Cavity and Paranasal Sinuses: A Meta-Analysis

Interobserver Variation Among Pathologists in Evaluating Perineural Invasion for Oral Squamous Cell Carcinoma

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