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Sinonasal Oncocytic Papilloma-A Series of 20 Cases With Special Emphasis on Recurrences.

ABSTRACT: Objective:Reports on sinonasal oncocytic papilloma (SNOP) are scarce. The aim of this retrospective study was to evaluate the clinical features of this rarest form of sinonasal papilloma with special emphasis on the pattern of recurrences and on the potential factors predicting them. Study Design:Retrospective study. Methods:Between the years 1994 and 2016, 20 patients (mean age 66?years; range 30-87) were diagnosed with SNOP at the Department of Otorhinolaryngology-Head and Neck Surgery, HUS Helsinki University Hospital (Helsinki, Finland). Hospital charts were reviewed to record various medical and sociodemographic patient characteristics, and the archived histological specimens were re-evaluated. Postoperative follow-up time varied between 26?days and 167?months. Results:Maxillary sinus was the most common (60%) tumor location. None of the tissue samples showed dysplasia. Recurrence rate was 39% and the median time span to the first recurrence was 25?months (range 7-71). Smokers had more often a recurrence than nonsmokers (75% vs. 31%). Patients with perioperative purulent rhinosinusitis during the primary surgery had a higher recurrence rate compared with those without (60% vs. 31%). Tumors located in the sinuses recurred more often than those located in the nasal cavity (45% vs. 29%). However, all these findings remained statistically nonsignificant. None of the cases showed malignant transformation during the follow-up. Conclusion:SNOP has a propensity to recur. History of smoking, purulent rhinosinusitis during the primary surgery, and tumor location in the sinuses outside the nasal cavity seem to contribute to an increased trend in the risk of recurrence. Level of Evidence:4.

SUBMITTER: Lilja M

PROVIDER: S-EPMC6929580 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Sinonasal Oncocytic Papilloma-A Series of 20 Cases With Special Emphasis on Recurrences.

Lilja Markus M Viitasalo Sanna S Hytönen Maija M Haapaniemi Aaro A Hagström Jaana J Mäkitie Antti A

Laryngoscope investigative otolaryngology 20190930 6

<h4>Objective</h4>Reports on sinonasal oncocytic papilloma (SNOP) are scarce. The aim of this retrospective study was to evaluate the clinical features of this rarest form of sinonasal papilloma with special emphasis on the pattern of recurrences and on the potential factors predicting them.<h4>Study design</h4>Retrospective study.<h4>Methods</h4>Between the years 1994 and 2016, 20 patients (mean age 66 years; range 30-87) were diagnosed with SNOP at the Department of Otorhinolaryngology-Head an ...[more]

PMID: 31890872

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Project description:There have been a few case reports and one small series of low grade papillary sinonasal (Schneiderian) carcinomas (LGPSC) which mimic papillomas but have overtly invasive growth and which occasionally metastasize. We describe the morphologic, clinical, immunohistochemical, and molecular features of five patients with LGPSC compared with eight cases each of inverted papilloma (IP) and conventional nonkeratinizing squamous cell carcinoma (SCC) with papillary growth. All LGPSC were nested with predominantly pushing invasion, no stromal reaction, and frequent surface papillary growth. All consisted of one cell type only, with polygonal cells with round nuclei, no (or limited) cytologic atypia, low mitotic activity, and prominent neutrophilic infiltrate. One patient had slightly more infiltrative bone invasion, another lymphovascular, perineural, and skeletal muscle invasion, and a third nodal metastasis after 17 years. By comparison, IPs had bland cytology, neutrophilic microabscesses, mixed immature squamous, goblet cell, and respiratory epithelium, and extremely low mitotic activity. Nonkeratinizing SCCs had basaloid-appearing cells with nuclear pleomorphism, brisk mitotic activity, and apoptosis. All LGPSC were p63 positive. Mitotic activity and Ki67 indices were significantly higher for LGPSCs than IPs and significantly lower than NKSCCs, while p53 immunohistochemistry in LGPSC was identical to nonkeratinizing SCC and higher than for IP. Sequencing showed all five tumors to harbor a MUC6 mutation, one tumor to harbor CDKN2A and PIK3R1 mutations, and one tumor to harbor a NOTCH1 mutation. All LGPSC lacked EGFR and KRAS mutations and lacked copy number variations of any main cancer genes. At a median follow up of 12 months, two LGPSC recurred locally, and one patient died after massive local recurrences and nodal metastases. LGPSC is a distinct, de novo sinonasal carcinoma that can be differentiated from papillomas by morphology and selected immunohistochemistry.

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Sinonasal Oncocytic Papilloma-A Series of 20 Cases With Special Emphasis on Recurrences.

Publications

Sinonasal Oncocytic Papilloma-A Series of 20 Cases With Special Emphasis on Recurrences.

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