Sinonasal Adenocarcinoma: Update on Classification, Immunophenotype and Molecular Features

Leivo, Ilmo

doi:10.1007/s12105-016-0694-9

Cited by 97 publications

(91 citation statements)

References 35 publications

(50 reference statements)

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“…RCC marker is also useful when positive, but is less sensitive. In this case, the CK7 and SOX-10 positivity and PAX-8 negativity, as was the case with our lesion argue against a metastatic clear cell RCC [7,16,17]. Metastatic melanoma, specifically with balloon cell morphology, and clear cell sarcoma (formerly clear cell melanoma of soft parts), are less likely given the strong CK7 positivity.…”

Section: Metastatic Clear Cell Lesionssupporting

confidence: 55%

Sinonasal Renal Cell-Like Carcinoma: Case Report and Review of the Literature

Kubik

Barasch

Choby

et al. 2016

Head and Neck Pathol

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recent WHO classification of primary sinonasal malignancies contains 44 distinct histopathologic entities [3]. Understandably, these cancers present a formidable challenge for both the surgeon and pathologist.In this article we present an unusual case of clear cell neoplasia of the paranasal sinuses found to be consistent with sinonasal renal cell-like adenocarcinoma (SNRCLA). The finding of clear cell neoplasia in a sinonasal specimen is rare but associated with a surprisingly wide differential diagnosis. When evaluating the differential diagnosis for a clear cell neoplasm of the sinonasal tract, an underlying renal cell carcinoma (RCC) must first be ruled out. RCC is the most common metastatic lesion to the nasal cavity and paranasal sinuses [4] and approximately 6-15% of patients with RCC will have metastatic deposits in the head and neck [5,6]. In addition to metastatic RCC, other diagnostic considerations for clear cell neoplasia in the paranasal sinuses include a clear cell variant of squamous cell carcinoma, melanoma, primary salivary clear cell carcinoma, metastatic clear cell thyroid carcinoma, clear cell predominant mucoepidermoid carcinoma, and SNRCLA. Case ReportAn 80 year old female presented to our otolaryngology clinic with an asymptomatic right sinonasal mass. She reported a history of left sided acinic cell carcinoma treated at an outside institution with endonasal resection and adjuvant radiotherapy approximately eight years prior. Diagnostic nasal endoscopy revealed a large friable soft tissue mass arising from the lateral nasal wall near the axilla of the right middle turbinate. Imaging revealed a 3 cm tumor centered at the right nasolacrimal sac with extension superiorly to involve the nasal septum and dura of the anterior Abstract The differential diagnosis for clear cell neoplasms of the sinonasal tract is wide but critical to understand. In this paper, we describe a case of renal cell-like adenocarcinoma (SNRCLA) presenting as a paranasal sinus mass with clear cell morphology. The relevant literature is reviewed and the workup for clear cell neoplasms described. SNRCLA is a rarely encountered low grade glandular malignancy of the paranasal sinuses. Despite its morphologic mimicry of renal cell carcinoma, SNRCLA demonstrates a seromucinous phenotype and is associated with a favorable prognosis and low recurrence rates after surgical resection.

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Section: Metastatic Clear Cell Lesionssupporting

confidence: 55%

Sinonasal Renal Cell-Like Carcinoma: Case Report and Review of the Literature

Kubik

Barasch

Choby

et al. 2016

Head and Neck Pathol

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“…Sinonasal AC has been divided into multiple subtypes broadly grouped into salivary and nonsalivary type ACs, the latter of which is further subdivided into intestinal type and nonintestinal type ACs. 24 Nonintestinal type AC has been closely linked to grade in which high-grade variants are associated with worse prognosis. 25 As the SEER database does not provide subtype differentiation of AC, the reported effect of grade is possibly due to the inclusion of nonintestinal type AC.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors in Paranasal Sinus Squamous Cell Carcinoma and Adenocarcinoma: A SEER Database Analysis

Jain

Kuan

et al. 2018

J Neurol Surg B

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Background Outcome studies on sinonasal malignancy are limited to retrospective case series, often with inclusion of diverse histology and short follow-up. The objective of this study was to identify key predictive variables that independently impact survival for paranasal sinus squamous cell carcinoma (SCC) and adenocarcinoma (AC) and to compare these variables in the context of these two distinct clinicopathologic entities. Methods: Analysis was conducted using the Surveillance, Epidemiology, and End Results database from 1973 to 2012 to identify key variables that impact survival for SCC and AC. Results A total of 3,714 cases were included. There were 2,895 SCC cases and 819 AC cases. The mean age at diagnosis was 64.1 years. The male to female ratio for SCC and AC was 1.85 and 1.04, respectively. Patients with SCC and AC were most often diagnosed with stage IV disease in 61.8 and 63.4% of cases, respectively. The majority of patients received combined surgery and radiation (52% for SCC and 43.1% for AC). For SCC, increased age (p < 0.001) and stage (p < 0.001) were negative predictors, and surgery improved survival (p < 0.001) on multivariate analysis. For AC, prognostic factors associated with worse survival include increased age (p < 0.001) and grade (p < 0.001) on multivariate analysis. Overall survival was significantly higher in AC compared with SCC at 5 years (p = 0.001). Conclusion SCC and AC of the paranasal sinuses are both aggressive malignancies with poor survival. For both histological subtypes, increased age predicts worse survival and grade also closely links to survival in AC. These data have important potential implications for treatment planning and pretreatment counseling.

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“…Recently, the impact of the tumor grade has been pointed out by Nicolai et al, 16 which is nearly statistically validated in this study (P 5 .0527) because the intestinal-type of adenocarcinoma of the mucinous subtypes were more aggressive. 38,39 This point should be explored in further studies.…”

Section: Discussionmentioning

confidence: 94%