Carcinoma ; diagnosis ; therapy ; Humans ; Paranasal Sinus Neoplasms ; diagnosis ; therapy

Objective: To analyze the efficacy of sinonasal adenoid cystic carcinoma (ACC) with perineural invasion (PNI), and explore the prognostic value of PNI on sinonasal adenoid cystic carcinoma. Methods: The clinical data of 105 patients with sinonasal ACC admitted to Cancer Hospital, Chinese Academy of Medical Sciences from January 2000 to December 2016 were retrospectively reviewed. All patients were restaged according to American Joint Committee on Cancer 8th edition. Follow-up visits were conducted to obtain information of treatment failure and survival outcome. The Log rank test was used for univariate analysis of prognostic factors, and Cox regression model was used for multivariate prognostic analysis. Results: The maxillary sinus (n=59) was the most common primary site, followed by the nasal cavity (n=38). There were 93 patients with stage Ⅲ-Ⅳ. The treatment modalities included surgery alone (n=14), radiotherapy alone (n=13), preoperative radiotherapy plus surgery (n=10), and surgery plus postoperative radiotherapy (n=68). The median follow-up time was 91.8 months, the 5-year local control (LC), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates were 72.6%, 73.0%, 52.9% and 78.0%, respectively. There were 33 patients (31.4%) with PNI-positive. The 5-year DMFS, PFS, and OS rates of PNI-positive group were 53.7%, 29.4% and 56.5%, respectively, which were significantly inferior to those of PNI-negative group (80.8%, 63.0% and 86.8%, respectively, P<0.05), while there was no significant difference in the 5-year LC rate between both groups (64.5% vs 76.5%, P=0.273). The multivariate Cox regression analysis showed PNI was one of the poor prognostic factors of DMFS (HR=3.514, 95%CI: 1.557-7.932), PFS (HR=2.562, 95%CI: 1.349-4.866) and OS (HR=2.605, 95%CI: 1.169-5.806). Among patients with PNI-positive, the 5-year LC, PFS and OS rates of patients received surgery combined with radiotherapy were 84.9%, 41.3% and 72.7%, respectively, which were significantly higher than 23.3%, 10.0% and 26.7% of patients receiving surgery or radiotherapy alone (P<0.05). Conclusion: The presence of PNI increases the risk of distant metastasis in patients with sinonasal ACC. Compared with patients with PNI-negative, the prognosis of patients with PNI-positive is relatively poor, and surgery combined with radiotherapy for PNI-positive sinonasal ACC results in good clinical outcomes.
Carcinoma, Adenoid Cystic/pathology* ; Humans ; Paranasal Sinus Neoplasms/therapy* ; Prognosis ; Proportional Hazards Models ; Retrospective Studies

Humans ; Nasal Cavity ; Nasopharyngeal Carcinoma/pathology* ; Neoplasm Recurrence, Local/therapy* ; Paranasal Sinuses ; Nose Neoplasms/therapy* ; Nasopharyngeal Neoplasms/pathology* ; Paranasal Sinus Neoplasms/pathology*

We report a case of 46-year-old xanthoderm woman who was diagnosed as malignant peripheral nerve sheath tumors of right maxillary sinus, and have a literature review. Histology confirmed a diagnosis of malignant peripheral nerve sheath tumor. The woman had the right total maxillectomy and postoperative adjuvant radiotherapy. There is no local recurrence or metastasis of one year following up. Literature review revealed MPNST in the nasal cavity and para-nasal sinuses were not common with poor prognosis. The main cause of death is local recurrence and metastasis. Surgical resection showed more advantage than adjuvant radiotherapy and chemotherapy.
Female ; Humans ; Maxillary Sinus ; Middle Aged ; Neoplasm Recurrence, Local ; Nerve Sheath Neoplasms ; pathology ; therapy ; Neurilemmoma ; pathology ; therapy ; Paranasal Sinus Neoplasms ; pathology ; therapy ; Radiotherapy, Adjuvant

Aged ; Cerebrospinal Fluid Rhinorrhea ; etiology ; prevention & control ; therapy ; Female ; Humans ; Male ; Nose Neoplasms ; radiotherapy ; Paranasal Sinus Neoplasms ; radiotherapy ; Young Adult

OBJECTIVETo evaluate the treatment outcome of different therapeutic modalities for squamous cell carcinoma of the nose and ethmoid sinus and prognostic factors.

METHODSOne hundred and forty-six cases of squamous cell carcinoma of the nose and ethmoid sinus treated from 1990 to 2007 were reviewed. Of the 146 cases, 28 were at stage I or II; 46 stage III; 72 stage IV. Forty-one patients were treated with preoperative radiation plus surgery (R + S), 22 patients with surgery plus postoperative radiation (S + R), 5 patients with surgery alone (SA), 78 patients with radiotherapy alone (RA).

RESULTSThe overall 5 year survival rate of 146 patients with squamous cell carcinoma of the nose and ethmoid sinus was 49.1%. The 5 year survival rate of the patients at stage I and II was 95.7%, while the rate was 59.8% in the patients at stage III and 28.2% in the patients at stage IV (χ(2) = 24.15, P < 0.05). The 5 year survival rate was 57.7% in R + S group, 60.4% in S + R group, 100% in SA group, and 38.8% in RA group, respectively (P > 0.05). The 5 years survival rate of N+ patients was lower than that of N0 (χ(2) = 12.326, P < 0.05). Local recurrence and distant metastasis were main causes of death. Cox analysis showed TNM stage and differentiation of tumor were independent significant prognostic factors.

CONCLUSIONSThe higher survival rate of patients with squamous cell carcinoma of the nose and ethmoid sinus was obtained from combined therapy R + S or S + R. SA gave ideal results for early lesions (stage I and II).

Adolescent ; Adult ; Aged ; Carcinoma, Squamous Cell ; pathology ; therapy ; Child ; Ethmoid Sinus ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Paranasal Sinus Neoplasms ; pathology ; therapy ; Prognosis ; Young Adult

OBJECTIVETo explore the diagnosis and treatment and prognosis of sinonasal neuroendocrine carcinoma.

METHODSThe clinical data of 11 cases with sinonasal neuroendocrine carcinoma treated in Zhejiang Cancer Hospital from 1998 to 2010 were analyzed retrospectively. Ten cases were small cell type and one case was atypical carcinoid. One case by only operation, one case by only radiotherapy, one case by only chemotherapy, two cases by radiotherapy and chemotherapy, 6 cases by combined treatment based on surgery (surgery combined with radiotherapy and chemotherapy).

RESULTSAll cases have been followed up for 2 months to 12 years. Six cases by combined treatment one case died in 3 years and one case died in 4 years after treatment, one case has survived without tumor for 12 years and two cases have survived without tumor for 8 years, one case was still in treatment. Five cases of other treatment programs, four cases died in 12 months, one case died in 18 months.

CONCLUSIONSThere's no standard treatment plan. Combined treatment based on surgery should be adopted to nasal neuroendocrine carcinoma. Reccurrence is frequent and the prognosis is poor. The key to improving the survival rate of the disease is early accurate diagnosis and combined treatment.

Adult ; Aged ; Carcinoma, Neuroendocrine ; diagnosis ; therapy ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; diagnosis ; therapy ; Paranasal Sinus Neoplasms ; diagnosis ; therapy ; Prognosis ; Retrospective Studies

OBJECTIVETo investigate the clinical features, therapeutic methods and therapeutic effects of sinonasal hemangiopericytoma.

METHODSClinical data of 6 patients with sinonasal hemangiopericytoma, diagnosed by pathology and immunohistochemistry between January 1990 and December 2012 were analyzed retrospectively. There were 4 males and 2 females, with a median age of 58 years. Clinical manifestation included epistaxis and nasal obstruction. These patients were operated on by nasal endoscopic surgery or endoscope-assisted surgery, of which 2 cases of tumor located in the nasal cavity underwent nasal endoscopic surgery and 4 cases of tumor located in the nasal cavity and sinuses underwent endoscope-assisted surgery.

RESULTSAll the patients were followed up for a period of 6 months to 7 years after operation. Two cases recurred and 4 cases didn't recurred. One case recurred 6 months after operation and underwent second operation, with no recurrence by further one year follow-up. Another case recurred 17 months after operation and underwent second operation, with recurrence by further 9 months follow-up. This patient lived with tumor over two years.

CONCLUSIONSHemangiopericytomas are rarely found in the sinonasal cavity. Nasal endoscopic or endoscope-assisted surgery provides satisfactory effect.

Adult ; Aged ; Female ; Hemangiopericytoma ; diagnosis ; therapy ; Humans ; Male ; Middle Aged ; Nasal Cavity ; Nose Neoplasms ; diagnosis ; therapy ; Paranasal Sinus Neoplasms ; diagnosis ; therapy ; Prognosis ; Retrospective Studies

OBJECTIVETo discuss the clinical characteristics, diagnosis and treatment of esthesioneuroblastoma (ENB).

METHODSThe clinical data of 7 patients with ENB were analyzed retrospectively, and the clinical characteristics, diagnosis, surgical approaches and prognosis of the disease were discussed.

RESULTSThe 7 patients received surgical treatment combined with radiotherapy and chemotherapy. Tumor relapse occurred within one year in two cases, which were treated with a second operation combined with radiotherapy, and one patient died and one survived with tumor after a one-year follow-up.

CONCLUSIONEarly diagnosis of ENB can be difficult. Transnasal-frontal approach with nasal endoscope is effective approach to ENB treatment, and the patients may benefit from postoperative radiotherapy and chemotherapy to improve the prognosis.

Adult ; Esthesioneuroblastoma, Olfactory ; diagnosis ; therapy ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; Nose Neoplasms ; diagnosis ; therapy ; Paranasal Sinus Neoplasms ; diagnosis ; therapy ; Retrospective Studies ; Young Adult

OBJECTIVE: To review the pathological and clinical features and treatment of sinonasal malignant melanoma. METHOD: A retrospective analysis of 23 cases of sinonasal malignant melanoma. All the patients were conformed by histopathology, the most common symptoms were nasal obstruction and epistexis. Eight cases were treated with surgery, 8 with surgery and radiotherapy, 5 with surgery and chemotherapy, 2 with surgery and ra- diotherapy plus chemotherapy. RESULT: Twenty patients were followed up, the survival rates of 3 and 5 years were 50% (10/20) and 35% (7/20), respectively. CONCLUSION Sinonasal malignant melanoma has an aggressive behavior and easy recurrence and poor prognosis. Early diagnosis and reasonable treatment can increase the survival rate of the disease.
Humans ; Melanoma ; mortality ; pathology ; therapy ; Nasal Obstruction ; Neoplasm Recurrence, Local ; Nose Neoplasms ; mortality ; pathology ; therapy ; Paraganglioma ; Paranasal Sinus Neoplasms ; mortality ; pathology ; therapy ; Retrospective Studies ; Survival Rate