Sinonasal Undifferentiated Carcinoma: A 13-Year Experience at a Single Institution (original) (raw)
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Sinonasal Undifferentiated Carcinoma with Intracranial Extension
Skull Base, 2006
Aim: To report our experience in the management of sinonasal undifferentiated carcinoma (SNUC) over a period of 15 years. Study design: A retrospective case review of 13 patients with SNUC treated at the University of California, Davis, Medical Center (UCDMC) Center for Skull Base Surgery, over the past 15 years. Results: Most tumors arose in the ethmoid sinuses. All but 1 patient had a combined intracranial-extracranial resection through the anterior fossa-transcranial route and postoperative irradiation. The 13th patient had a transfacial subcranial approach. There are 6 who have survived free of disease at 14 years' to 8 months' follow-up. The average follow-up was 6 years, 3 months. One patient died of a pulmonary embolism in the first postoperative week, a second died of a bowel infarction 3 months postoperatively. Three patients died of their disease at 20, 18, and 8 months postoperatively: 1 with local recurrence and distant metastasis and the other 2 with local control but distant disease. The 6 survivors are at 8, 20, 28, 62, 84, and 105 months. Conclusion: SNUC is a rare malignancy of the paranasal sinuses with a poor prognosis. Radical surgery and adjunctive therapy can achieve good survival in a significant proportion of patients who would hitherto have seemed incurable.
Undifferentiated Sinonasal Carcinoma-Case Report
Journal of Pharmacy and Pharmacology 7 (2017) 434-438, 2017
SNUC (undifferentiated sinonasal carcinoma) is a rare tumor. The exact cause of this cancer is not known. Patients usually have signs and symptoms of bleeding from the nose, runny nose, duplicate photos, symptoms of chronic sinus infections and nose, nasal obstruction, or facial pain. We reported a case of seventy year old patient with sinonasal undifferentiated carcinoma in the right maxillary sinus. Six months ago, the patient was conducted operations polyp in the right nasal hall. He had pain in the right side of his face and swelling in the mouth in the area of the upper jaw on the right side. The patient was operated tumor of the right maxillary sinus, with expansion in the ethmoid sinus, nasal cavity and infratemporal space. The neck dissection was done on the same side. Postoperatively, he received radiation therapy and chemotherapy. SNUC is very rare aggressive cancer that requires aggressive therapy. This cancer is considered in need of modified maxillary sinuses, as well as for modified sinus in polyps or after the operation of the same. Despite extensive surgery, radio therapy and implemented chemotherapy, the prognosis of these tumors is very poor.
Evaluation of Patients with Sinonasal and Ventral Skull Base Malignancies
Otolaryngologic Clinics of North America, 2017
Work-up of sinonasal and ventral skull base malignancies requires thorough history and physical examination, augmented by modern imaging techniques and histological evaluation. Lesions of the paranasal sinuses and ventral skull base often present in advanced stages, involving adjacent structures. Optimal treatment planning requires a multidisciplinary approach involving otolaryngology, ophthalmology, neurosurgery, plastic and reconstructive surgery, and oncology teams. The wide variety of cell types gives rise to an uncommon group of pathology. Definitive treatment requires an understanding of their etiologies and pattern of spread.
Challenges in the treatment of sinonasal undifferentiated carcinoma: a ray of hope
The Medical journal of Malaysia, 2005
We studied nine cases of SNUCs presented to the Department of Otorhinolaryngology, Hospital University Kebangsaan Malaysia from 1999 to 2003. There were 8 males and 1 female with ages ranging from 24 to 78 years (mean 46.5y). The racial distribution consisted of 5 Chinese (55.5%), 3 Malays (33.3%) and 1 Indian (11.1%). Three patients were Kadish B (33.3%) and six were Kadish C (66.6%) by classification. In our series 2 years survival was 26.3% and median survival time was 14.2 months.
Journal of Neurosurgery, 2022
S inonaSal cancers (SNCs) are rare aggressive entities with an incidence of 0.83 per 100,000 persons, representing only 3% of head and neck cancers. 1,2 Complete resection with negative margins is the mainstay of treatment for SNC and has been shown to improve outcomes. 3-5 Multimodal treatment that is tailored to histology, centered on surgery, and incorporates radiotherapy and chemotherapy has emerged as the standard treatment approach for these complex tumors. 6-8 As a part of the multidisciplinary approach to SNC treatment, neoadjuvant chemotherapy and neoadjuvant radiation therapy have shown promising results, with reports of increased likelihood of negative surgical margins. 5,9 The 5-year progression-free survival (PFS) rate of patients with SNC was 52% in a large institutional series that included 225 patients who were treated surgically for SNC over a 28-year period. Of the recurrences, 59% were local, 37% were distant, and 4% were both local and distant recurrences. The 5-year overall survival (OS) rate was 65%. 10 Patients with recurrent SNCs (RSNCs) whose first-line therapy has failed often present with extensive involvement of the skull base and exhibit high rates of subsequent recurrence and death. These are particularly challenging pathologies to treat, with limited data guiding the role of salvage surgery, adjuvant radiation, and/or chemotherapy. 11-15 Salvage resection remains technically challenging owing to extensive local invasion of the nasal cavity, paranasal sinuses, skull base, and orbit and risk to vital neuro-ABBREVIATIONS OS = overall survival; PFS = progression-free survival; RSNC = recurrent SNC; SNC = sinonasal cancer; SNUC = sinonasal undifferentiated carcinoma.
The Laryngoscope, 2000
Objective: Sinonasal undifferentiated carcinoma (SNUC) and sinonasal neuroendocrine carcinoma (SNEC) are relatively newly recognized, rare entities requiring further clinicopathological analysis to advance our understanding and determine prognostic distinctions between them. Study Design: Retrospective chart review. Methods: Cases were retrieved from the Copath system. One patient was seen in consultation from an outside institution. Histological and immunohistochemical findings, patient demographics, treatment regimens, and outcomes were analyzed and compared. Results: Ten patients (7 men, 3 women) ranging in age from 17 to 58 years (mean age, 44.7 y) were included. Four patients were classified with SNEC, six as having SNUC. The predominant site was the superior nasal cavity or ethmoids (seven cases), followed by the maxilla (four cases). Disease in four patients was clinically staged as N1 (three with SNUC, one with SNEC), and in six patients as N0 (three with SNEC, three with SNUC). Of the nine patients who were treated initially with surgical resection, seven received postoperative radiation therapy alone, one received postoperative radiation and chemotherapy, and one had only limited postoperative chemotherapy. One patient was treated with radiation therapy and chemotherapy alone, without surgical resection. Follow-up was obtained ranging from 6 to 108 months (mean period, 26.4 mo). Three patients died of disease 10, 14, and 41 months, respectively, after diagnosis. Three patients had persistent disease at 6, 9, and 21 months, respectively, two of them with distant metastases. Four patients were disease free after 6, 18, 31, and 108 months, respectively.
Annals of Maxillofacial Surgery
Original Article-Retrospective Studies IntRoductIon Malignancies of sinonasal region are a rare group of tumors with a reported incidence of 1 in 100,000 people annually. [1,2] The incidence of these tumours ranges from 0.2% to 0.8% in all cancers and up to 3%-5% of all head-and-neck malignancies. [3,4] The incidence is higher in Asian and African countries as compared to the United States and European countries. It is the second most common malignancy of the subgroup of head-and-neck cancers in Asian countries whereas the most common malignancy is nasopharyngeal cancer. [5,6] T h e m o s t c o m m o n s i t e o f o r i g i n o f s i n o n a s a l malignancies (SNMs) is maxillary sinus followed by ethmoid sinus. Frontal and sphenoid sinuses rarely present as primary site of origin of SNM. [1,7] Management of SNM is difficult as they are usually in close relation or adherent to surrounding structures such as skull base and orbit. [5,8,9] SNMs are more commonly seen in males with a male-to-female ratio of 2.3:1. [10] Patients with SNM are usually more than 40 years of age. In the initial stages, these tumours are usually misdiagnosed due to their nonspecific features and late presentation. [11,12] Due to delayed presentation of these tumours, it becomes extremely difficult to determine the exact site of origin because of extensive involvement of surrounding structures. [13,14] Unlike squamous cell carcinoma of other sites in head-and-neck region, lymph node metastasis in SNM is not commonly seen, with incidence ranging from 3.3% to 26%. [1] The most common histologies are squamous cell carcinoma followed
Clinico-pathological spectrum of sinonasal masses: a tertiary care hospital experience
International Journal of Otorhinolaryngology and Head and Neck Surgery
INTRODUCTION Sinonasal masses (SNM) are a fairly common clinical entity that occurs amongst patients of all age groups and are encountered routinely in ENT outpatient departments. They encompass a very wide range of pathologies ranging from non-neoplastic to neoplastic in nature. 1 Their presenting features are diverse and depend upon the type, spread and extent of the primary disease. Accordingly, the patients may have nasal features (obstruction, discharge, nasal mass, epistaxis, smell abnormalities), features of oro-facial involvement (palatal or buccal swelling, loose teeth, facial pain and swelling), orbital features (epiphora, proptosis, diplopia), aural features (fullness, hearing impairement), and/or metastatic neck nodes. 2 These masses can be congenital or acquired. Congenital masses such as dermoid cysts, glioma and encephaloceles are predominantly midline swellings, and may present either intranasally or extranasally. 3,4 Acquired sinonasal masses can be inflammatory including allergic, traumatic, granulomatous or neoplastic (benign and malignant) in nature. 5 Aquired pathologies presenting with sinonasal ABSTRACT Background: Sinonasal masses (SNM) are a fairly common clinical entity that occurs amongst patients of all age groups. There symptoms and signs frequently overlap, hence a diagnostic dilemma exists. A correct diagnosis is prudent for instituting correct treatment and expecting recovery. The purpose of this retrospective analysis was to decipher and study the various pathologies that present as sinonasal masses. Methods: A retrospective analysis done on 80 patients of SNM who presented to the Department of ENT, Subharti Medical College and Hospital, Meerut from May 2016 to April 2017. Their biodata, clinical profile and histolopathological diagnosis were analyzed. Results: SNM were male predominant and were non-neoplastic in 53 cases (66.25%). Nasal obstruction was the most common presenting feature (71 cases, 88.75%). Nasal polyps are the most commonly encountered SNM. Nonneoplastic SNM were common in the age group of 11 to 40 years. Benign SNM were common during the 2 nd to 4 th decade of life, while malignant SNM were common from 5 th decade onwards. Conclusions: SNM constitute a very wide spectrum of differential diagnoses. They have a male predominance and majority are non-neoplastic. Nasal polyps are the most commonly encountered SNM, seen during 2 nd to 4 th decade of life, while squamous cell carcinoma is the most commonly encounterd malignancy, generally from 5 th decade onwards. Surgery is the treatment of choice.