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Metastatic Tumors of the Sinonasal Cavity: A 15-Year Review of 17 Cases.

ABSTRACT: Extranasal cancers that metastasize to the sinonasal cavity are very rare. To date, there are only limited reports regarding this rare condition within the literature. Therefore, we retrospectively reviewed all patients diagnosed with metastatic cancer of the sinonasal tract from 2003 to 2018 at a tertiary academic medical center. Patient demographic data, clinical presentation, treatment modalities, and outcomes were investigated. There were a total of 17 patients (9 males and 8 females) included in the analysis. The mean age was 56.8 years (range 27-80). The most common primary malignancies were hepatocellular carcinoma (n = 3) and gastrointestinal tract adenocarcinoma (n = 3). The most common site of metastasis was the nasal cavity (n = 8). Five patients received radical tumor resection and the others underwent radiotherapy, chemotherapy, or combined chemoradiotherapy. The 2-year survival was 28%. In summary, metastasis to the sinonasal cavity remains extremely rare. A high degree of suspicion regarding the possibility of metastatic spread to the sinonasal region is necessary for patients with a previous history of malignancy who present with new sinonasal symptoms. The treatment strategy of sinonasal metastatic cancer is usually palliative therapy and the prognosis remains poor. However, early detection and diagnosis, coupled with aggressive treatment, may improve patient quality of life.

SUBMITTER: Chang MH

PROVIDER: S-EPMC6517969 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Human sinonasal cavity

Project description:Human sinonasal cavity Targeted loci environmental

| PRJNA407725 | ENA

Metastatic renal cell carcinoma to the sinonasal cavity: a case series.

Project description:Objectives To describe the presentation, work-up, and management of patients with metastatic renal cell carcinoma (RCC) to the sinonasal cavity and skull base, and to describe our current treatment algorithm of endoscopic surgical resection followed by radiation therapy. Design Retrospective review of two recent cases from our institution over a 1-year period, with a relevant review of the literature. Setting A large regional tertiary care facility. Participants Consecutive cases of RCC with metastases to the sinonasal cavity presenting to our institution. Main Outcome Measures Preoperative and postoperative sinonasal outcome test (SNOT)-22 scores, duration of hospital stay, complications, and local disease control Results Patients in this series underwent preoperative embolization followed by endoscopic resection without complication. Postoperatively they were treated with radiation therapy. They experienced improvement in their SNOT-22 scores and are currently free of local disease. Conclusion Metastatic RCC to the sinonasal cavity can be safely treated with preoperative embolization followed by endoscopic surgical resection and radiation therapy, which can result in improvement in sinonasal quality of life and is a potential adjunct for local control of disease.

| S-EPMC3836888 | biostudies-other

Sinonasal mucosal melanoma: a 10-year experience of 36 cases in China.

Project description:BackgroundSinonasal mucosal melanoma (SNMM) is a rare tumor with a poor prognosis. This study aimed to assess the clinical and imaging features, progression, treatment, and possible prognostic factors of SNMM.MethodsThirty-six patients with SNMM were retrospectively reviewed in the Department of Otolaryngology & Head and Neck Surgery of Xinhua Hospital from January 2008 to December 2017.ResultsThe age of the first diagnosis was 67.4±10.8 years; the most common clinical symptoms included epistaxis, nasal obstruction, headache, and facial pain. Most tumors originated in the nasal cavity (63.9%) and at stage IV (77.8%). Melanin in melanoma showed typical signal intensity on magnetic resonance imaging (MRI), T1WI had high signal while T2WI had low signal. 41.6% of patients had the typical MRI findings. Treatment included surgery, surgery with radiotherapy, and radiotherapy only. The follow-up time ranged from 4 to 96 months, with a median time of 22 months, 1-, 3-, and 5-year OS is 80.6%, 36.1%, and 13.9%, respectively. The 3-year OS was better in cases in the T3 stage than the T4 stage (P=0.02). However, tumors that originated from the paranasal sinus had a poorer prognosis than the nasal cavity (P=0.04). The cases receiving postoperative radiotherapy showed poorer prognosis (P=0.02). Other factors were not found to be associated with prognosis, including gender, age, lymph node metastasis, distant metastasis, computed tomography (CT) enhancement, and typical MRI findings.ConclusionsThe SNMM was a devastating tumor with poor outcomes; most cases were diagnosed at late stages, which may account for poor prognosis. Tumors with melanin feature MRI findings do not have a better prognosis. The treatment of postoperative radiotherapy is still controversial.

| S-EPMC7475479 | biostudies-literature

Sinonasal Osteosarcoma: Report of 14 New Cases and Systematic Review of the Literature.

Project description:Objective The objective of this study is to describe the clinical presentation, tumor characteristics, natural history, and treatment patterns of sinonasal osteosarcoma. Methods Fourteen patients who had been treated for osteosarcoma of the nasal cavity and paranasal sinuses at a tertiary care center were reviewed. In addition, a systematic review of the literature for osteosarcoma of the sinonasal cavity was performed. Results In a systematic review, including 14 patients from the authors' institution, 53 total studies including 88 patients were assessed. Median follow-up was 18 months (interquartile range: 8-39 months). The most common presenting symptoms were facial mass or swelling (34%), and nasal obstruction (30%). The most common paranasal sinus involved by tumor was the maxillary sinus (64%), followed by the ethmoid sinuses (52%). The orbit (33%), dura (13%) and infratemporal fossa (10%) were the most common sites of local invasion. The majority of patients underwent surgery followed by adjuvant therapy (52.4%). Increasing age was associated with decreased overall survival rate (unit risk ratio [95% confidence interval (CI)] = 1.02 [1.003-1.043]; p = 0.0216) and T4 disease was associated with decreased disease-specific survival rate (hazard ratio [HR] = 2.87; p = 0.0495). The 2- and 5-year overall survival rates were 68 and 40%, respectively, while 2- and 5-year disease-specific survival rates were 71% and 44%, respectively. Conclusion Sinonasal osteosarcomas are uncommon tumors and can pose a significant therapeutic challenge. Increasing age and T4 disease are associated with worse prognosis. This disease usually warrants consultation by a multidisciplinary team and consideration of multimodality therapy.

| S-EPMC8289535 | biostudies-literature

Ocular and periocular radiation toxicity in dogs treated for sinonasal tumors: A critical review.

Project description:Visual impairment from radiation-induced damage can be painful, disabling, and reduces the patient's quality of life. Ocular tissue damage can result from the proximity of ocular organs at risk to irradiated sinonasal target volumes. As toxicity depends on the radiation dose delivered to a certain volume, dose-volume constraints for organs at risk should ideally be known during treatment planning in order to reduce toxicity. Herein, we summarize published ocular toxicity data of dogs irradiated for sinonasal tumors from 36 publications (1976-2018). In particular, we tried to extract a dose guideline for a clinically acceptable rate of ocular toxicity. The side effects to ocular and periocular tissues were reported in 26/36 studies (72%) and graded according to scoring systems (10/26; 39%). With most scoring systems, however, toxicities of different ocular and periocular tissues are summed into one score. Further, the scores were mostly applied in retrospect and lack volume- and dose-data. This incomplete information reflects the crux of the matter for radiation dose tolerance in canine ocular tissues: The published information of the last three decades does not allow formulating dose-volume guidelines. As a start, we can only state that a mean dose of 39 Gy (given in 10 x 4.2 Gy fractions) will lead to loss of vision by one or both eyes, while mean doses of <30 Gy seem to preserve functionality. With a future goal to define tolerated doses and volumes of ocular and periocular tissues at risk, we propose the use of combined ocular toxicity scoring systems.

| S-EPMC7496316 | biostudies-literature

Craniofacial Resection for Sinonasal Malignant Tumors: Statistical Analysis of Surgical Outcome over 17 Years at a Single Institution.

Project description:We present a retrospective analysis of surgical outcome of sinonasal malignant tumors. Overall survival (OS), disease-specific survival (DSS), local control (LC), and disease-free survival (DFS) were calculated in 32 patients. Prognostic factors for survival and functional outcomes were investigated. The median follow-up period was 70 months. At 5 years, OS, DSS, LC, and DFS rates were 0.722, 0.745, 0.851, and 0.707, respectively. Prognostic factors for poor OS were involvement of the frontal sinus (p = 0.023), T classification (T4, p = 0.025), surgical complications (p = 0.029), chemotherapy (p = 0.035) postsurgical infection (p = 0.043), involvement of the orbit (p = 0.048), histology (squamous cell carcinoma, p = 0.049), and radiotherapy (p = 0.043). Prognostic factors for poor DSS were radiotherapy (p = 0.030), chemotherapy (p = 0.036), positive surgical margin (p = 0.034), and T classification (T4, p = 0.050). LC was adversely influenced by surgical procedure (combined frontotemporal resection, p = 0.035) and positive surgical margin (p = 0.049). DFS was adversely influenced by positive surgical margin (p = 0.001). Prognostic factors for poor functional outcome were postsurgical infection (p = 0.039), postsurgical complications (p = 0.040), tumor location (maxillary sinus, p = 0.042, orbit, p = 0.0002), number of sinuses involved (number of sinuses involved was inversely proportional to functional outcome, p = 0.027), T classification (T4 p = 0.007), pathology (squamous cell carcinoma, p = 0.023), and chemotherapy (p = 0.048). Craniofacial resection was an effective surgical option.

| S-EPMC3312121 | biostudies-other

Biomarkers for Immunotherapy in Poorly Differentiated Sinonasal Tumors

Project description:The sinonasal cavities harbor a wide variety of rare cancer types. Histopathological classification can be challenging, especially for poorly differentiated tumors. Despite advances in surgery and radio-chemotherapy, the 5-year survival rate is still very low. Thus, there is an unmet clinical need for new therapeutic options. We retrospectively evaluated poorly differentiated tumors of 9 different histological subtypes from 69 patients who had received conventional treatments for the presence of CD8+ tumor-infiltrating lymphocytes (TILs), as well as the expression of PD-L1 and microsatellite instability (MSI) markers MLH1, MSH2, MSH6 and PMS2, as biomarkers for immunotherapy. CD8+ TILs were present in 23/69 (33%) cases, PD-L1 expression was observed in 23/69 (33%), and markers for MSI positivity in 5/69 (7%) cases. CD8+ TILs correlated with PD-L1 positivity, while both were mutually exclusive with MSI markers. None of the biomarkers were associated with clinical features as age, gender or tumor stage. Cases with CD8+ TILs and PD-L1 positivity showed a tendency toward worse disease-specific survival. Immune checkpoint inhibitors are emerging as new options for treatment of many tumor types. Our results indicate that also a substantial subset of patients with poorly differentiated sinonasal tumors may be a candidate to be treated with this promising new therapy.

| S-EPMC9496628 | biostudies-literature

Physical Activity in 15-17-Year-Old Adolescents as Compensation for Sedentary Behavior in School.

Project description:The traditional concept of education and school settings significantly contribute to the sedentary behavior of adolescents at secondary schools. The aim of this study is to identify the volume and intensity of physical activity (PA) that adolescent boys and girls engage in during recesses, after school, and during the day to compensate for sedentary behavior in lessons. The study was conducted at 29 Czech and 9 Polish schools. The study involved 868 girls and 409 boys aged 15-17 years. An ActiTrainerTM accelerometer was used to monitor PA and heart rate. Participants were divided into four quartile groups. Most sedentary boys and girls had less PA and showed a worse ratio of physical inactivity (PI)/PA than non-sedentary participants during recesses. In the after-school period, there were no significant differences. On school days, most sedentary boys and girls showed lower PA, a worse ratio of PI/PA, fewer steps·hour-1, and lower energy expenditure than their non-sedentary counterparts. Vigorous PA of ?8 METs was reached by 48% of most sedentary boys (75% non-sedentary) and 47% of most sedentary girls (54% non-sedentary). Most sedentary adolescents do not compensate for their sedentary behavior in lessons with higher PA intensity or volume during recesses, after-school, or in overall daily PA.

| S-EPMC7246541 | biostudies-literature

Primary Clear Cell Microcystic Adenoma of the Sinonasal Cavity: Pathological or Fortuitous Association?

Project description:Primary clear cell microcystic adenoma of the sinonasal cavity is rare. It has previously been described only as a VHL-associated tumour. Von Hippel-Lindau (VHL) syndrome is an inherited cancer syndrome characterised by an elevated risk of neoplasia including clear cell renal cell carcinoma (ccRCC), haemangioblastoma, and phaeochromocytoma. We describe the second reported case of a primary clear cell microcystic adenoma of the sinonasal cavity. The 39-year-old patient with VHL syndrome had previously undergone resection and ablation of ccRCC. He presented with epistaxis. Imaging demonstrated a mass in the ethmoid sinus. Initial clinical suspicion was of metastatic ccRCC. However, tumour morphology and immunoprofile were distinct from the previous ccRCC and supported a diagnosis of primary microcystic adenoma. Analysis of DNA extracted from sinonasal tumour tissue did not show loss of the wild-type allele at the VHL locus. Although this did not support tumour association with VHL disease, it was not possible to look for a loss-of-function mutation. The association of primary microcystic adenoma of the sinonasal cavity with VHL disease remains speculative. These lesions are benign but are likely to require regular surveillance. Such tumours may require repeated surgical excision.

| S-EPMC5316451 | biostudies-literature

Epidemiological characteristics of central nervous system tumors in children: a 5-year review of 3180 cases from Beijing Tiantan Hospital.

Project description:BackgroundTo describe the epidemiological characteristics of central nervous system (CNS) tumors in children, based on the neurosurgery department of Beijing Tiantan Hospital.MethodsFrom January 2015 to December 2019, 3180 children were histopathologically diagnosed with CNS tumors based on the 2016 World Health Organization (WHO) classification of tumors. Patients were 0 to 15 years old. We analyzed age-related gender preferences, tumor locations, and the histological grades of the tumors. In addition, the epidemiological characteristics of the five most common intracranial tumors were compared to the previous studies.ResultsIn this study, intracranial and spinal tumors account for 96.4% (3066) and 3.6% (114) of all tumors, with a preponderance of supratentorial tumors (57.9%). Among all pediatric patients, low-grade tumors comprise 67.1% (2 135). The integral gender ratio of males to females is 1.47: 1 and the average age of patients is 7.59 years old. The five most common intracranial tumors are craniopharyngioma (15.4%), medulloblastoma (14.3%), pilocytic astrocytoma (11.8%), diffuse astrocytoma (9.8%), and anaplastic ependymoma (4.8%).ConclusionsDue to the lack of national data on childhood brain tumors, we used a large nationally representative population sample based on the largest pediatric neurosurgery center in China. We analyzed the data of the past 5 years, reflecting the incidence of CNS tumors in Chinese children to a certain extent, and laying a data foundation for subsequent clinical studies.

| S-EPMC9096059 | biostudies-literature

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