Uncommon and Atypical Sinonasal Masses: Diagnostic and Therapeutic Challenges

Sharma, Vinamra; Sharma, Rohit; Madhok, Rajneesh; Agarwal, Tanu; Mehrotra, Ashish; Kochhar, Anisha

doi:10.5005/jp-journals-10013-1130

Cited by 4 publications

(5 citation statements)

References 9 publications

(8 reference statements)

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“…18 Incidence of mucocele (1 case-2.44%) in our study matched that of Wahid FI et al 19 (2.22%). Sharma R et al 7 reported a higher incidence (7%) in their study of 223 cases.…”

Section: Discussionmentioning

confidence: 83%

“…5 It was the second most common non-epithelial benign neoplasm (16.67%) in the present series. Modh SK et al 6 and Sharma R et al 7 reported an incidence of 19.4% and 11% respectively in their studies.…”

Section: Discussionmentioning

confidence: 90%

“…The majority of sinonasal pathology is inflammatory, with neoplasms comprising approximately 3% of head and neck tumors. 7 The incidence of sinonasal lesions was 20.33 cases per year, averaging 0.47% of surgical pathology material received in the Department of Pathology. The incidence of non-neoplastic lesions in the sinonasal region was 13.67 cases per year.…”

Section: Discussionmentioning

confidence: 99%

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Morphological Spectrum of Lesions in the Sinonasal Region

Raj¹,

Sharmila²,

Shrivastava³

et al. 2013

jemds

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INTRODUCTION:Nasal cavity and paranasal sinuses present a range of non-neoplastic and neoplastic lesions by virtue of their anatomic and histologic diversity. Although a presumptive diagnosis is arrived at based on presenting symptoms and imaging techniques, histopathology is the mainstay for definitive diagnosis and management of sinonasal lesions. AIMS AND OBJECTIVES: To study the incidence, mode of presentation and histologic types of sinonasal lesions in surgical pathology material. SETTING AND DESIGN: Retrospective retrieval of all sinonasal lesions and histopathologic analysis. MATERIALS AND METHODS: All sinonasal lesions, biopsied or excised over a period of three years between May 2010 and May 2013, were studied. The lesions were classified as non-neoplastic or neoplastic. Neoplasms were further categorised as benign and malignant. The histology was correlated with clinical features. Special stains and immunohistochemistry were done wherever indicated. RESULTS: In three years, sixty-one sinonasal lesions were reported, representing 0.47% of all surgical pathology specimens. Out of sixty-one cases, forty-one (67.21%) were non-neoplastic and twenty (32.79%) were neoplastic. Sinonasal lesions were common in the second and third decades of life, with male predominance. Among the non-neoplastic lesions, inflammatory polyps were the most common (80.49%). Among neoplasms, benign tumors (60%) were more frequent than malignant tumors (40%). Angiofibroma (6 cases-50%) was the commonest benign neoplasm and squamous cell carcinoma (4 cases-50%) was the commonest malignant neoplasm. CONCLUSION: Non-neoplastic and neoplastic lesions in the sinonasal region have similar clinical manifestations. Categorization based on histopathology is necessary for differential diagnosis, management and prognosis of these uncommon lesions. KEY WORDS: nasal cavity, paranasal sinuses, non-neoplastic, neoplastic, histopathology INTRODUCTION:The nasal cavity and paranasal sinuses form a functional unit of specialized tissues, each with its own aberrations. 1 They share many pathologic processes, most of which are inflammatory. 2 Exposure to various influences like chemical irritants, antigenic stimulants, and mechanical trauma results in deleterious consequences, including formation of tumors and tumorlike conditions. 3 Inflammatory polyps are a common cause of nasal obstruction, with a prevalence of 4% in the general population. 4 Benign tumors are relatively common, but malignant neoplasms are rare, accounting for 0.2-0.8% of all carcinomas and only 3% of those in the upper aero digestive tract. 5 Most of these lesions present as polypoid masses, making it difficult to distinguish nonneoplastic polyps from polypoid neoplasms clinically. 6 Histopathologic diagnosis is therefore mandatory for appropriate management and prognosis of sinonasal lesions. This study was undertaken to classify sinonasal lesions based on histopathology and to analyze their age and sex distribution.

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“…18 Incidence of mucocele (1 case-2.44%) in our study matched that of Wahid FI et al 19 (2.22%). Sharma R et al 7 reported a higher incidence (7%) in their study of 223 cases.…”

Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Morphological Spectrum of Lesions in the Sinonasal Region

Raj¹,

Sharmila²,

Shrivastava³

et al. 2013

jemds

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“…These results emphasize the overall malignant transformation potential to about 1-2% [12]. However, the incidence of oral and upper respiratory tract SCC is on the rise with a high level of recurrence [13,14,15,16]. This necessitates a better understanding of the neoplastic transformation at cellular level.…”

Section: Introductionmentioning

confidence: 91%

A Study of Lesions of Upper Respiratory Tract

Anbukkarasi

Ganapathy

Thanka

2021

JPRI

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The development of the organ systems are highly regulated in physiological conditions and the development of nose and paranasal sinuses commences in the 3rd week of gestation, when the primordial structures first appear and continues until completion in early adulthood when sinus pneumatization and bony growth have ceased. Their misregulation lead to the development of many cancers and primitive nasal septum Squamous cell carcinoma (SCC) of the upper respiratory tract ranks as the sixth leading cause of cancer worldwide.In the current study, out of 31 cases, maximum cases were found to be moderately differentiated grade amounting to 64.5%, followed by well differentiated grade (22.6%) and poorly differentiated grade (12.9%). The present study also showed that poorly differentiated SCC had higher Ki 67 proliferative index and it could be a useful tool for determining the stages of tumors. Ki 67 proliferative index study of the tumor helps in better understanding of the tumor behavior so as to provide appropriate treatment and thereby increasing the survival rate of the patient.

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“…The majority of sinonasal pathology is inflammatory and neoplasms comprising of 3% of head and neck tumors. 6 Almost all sinonasal masses present with varying symptoms of nasal obstruction, epistaxsis, nasal discharge, loss of smell or change in perception of smell, oral symptoms, facial swelling, orbital symptoms and ear symptoms. 7 A detailed history, clinical examination, diagnostic nasal endoscopy and advanced imaging (CT scan) are required to make a presumptive diagnosis.…”

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confidence: 99%

Clinico-pathological and radiological assessment of benign nasal masses

Sharma

Garg²,

Baisakhiya³

2017

Int J Otorhinolaryngol Head Neck Surg

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Background: Sinonasal masses are uni or bilateral with variable and with multiple etiological factors. Benign masses are common in comparison to malignant in this region. Some of the benign masses e.g. juvenile angiofibroma and inverted papilloma cause local bony destruction. Preoperative radiological assessment is desirable for proper surgical Management. The purpose of the study was to assess the clinical and radiological findings of sinonasal masses and the correlation of the clinical and radiological findings with the histopathology.Methods: This prospective study was carried out on 50 cases if intra nasal masses. After clinical examination, these patients were subjected to radiology. The parameters assessed were the origin, extension, involvement of adjacent structure. Subsequently, all the cases were subjected to surgery i.e. polypectomy, medial maxillectomy, excision with the help of nasal endoscope. Thereafter, the histopathological findings were correlated with clinical and radiological findings. Results: Total 50 cases of intra nasal benign masses were included in the study. Among them 36 (72%) cases were of nasal polyps, out of which 29 (80.5%) were inflammatory polyps and 7 (19.4%) were allergic polyps. Among inflammatory polyps, 23 (79.3%) were males and 6 (20.69%) were females. Among allergic polyps 4 (57.14%) were males and 3 (42.85%) were females. The other findings were 5 (10%) cases of angiofibroma, 5 (10%) cases on inverted papilloma, 3 (6%) cases of haemangioma and 1 (2%) cases of chondrosarcoma.Conclusions: Considering the result obtained, the most common sinonasal lesions were inflammatory polyps. Others in order in order of frequency were allergic polyp, angiofibroma, inverted papilloma, haemangioma and chondrosarcoma.

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Uncommon and Atypical Sinonasal Masses: Diagnostic and Therapeutic Challenges

Cited by 4 publications

References 9 publications

Morphological Spectrum of Lesions in the Sinonasal Region

Morphological Spectrum of Lesions in the Sinonasal Region

A Study of Lesions of Upper Respiratory Tract

Clinico-pathological and radiological assessment of benign nasal masses

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