3.The outcome of transnasal endoscopic total maxillectomy in the treatment of sinonasal adenoid cystic carcinoma.
Quan LIU ; Yuting LAI ; Jingyi YANG ; Huankang ZHANG ; Xicai SUN ; Yurong GU ; Houyong LI ; Hongmeng YU ; Dehui WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(4):243-251
Objective:To assess the prognosis of sinonasal adenoid cystic carcinoma with hard palatine invasion treated by transnasal endoscopic total maxillectomy. Methods:Clinical data of twenty-six patients with sinonasal adenoid cystic carcinoma invading hard palatine treated by transnasal endoscopic total maxillectomy between May 2014 and December 2020 was analyzed retrospectively. Survival rate, local recurrence and distant metastasis were analyzed using Kaplan-Meier method. Cox regression was used to investigate the prognosis factors. Masticatory function after maxillectomy has also been assessed using the questionnaire of patients' satisfaction about masticatory function. Results:Margins in 8 patients(30%) were positive. The median time of follow-up was 38 months(6 to 85 months). Twenty-five patients recurred. Four patients died of distant metastasis. The 5-year overall survival rate and relapse-free survival rate was 79.5% and 89.1%, respectively. Independent predictors of outcome on multivariate analysis were positive margin(P=0.018), recurrence(P=0.006) and distant metastasis(P=0.04). Conclusion:Transnasal endoscopic total maxillectomy could be performed for the treatment of the sinonasal adenoid cystic carcinoma with hard palatine invasion. Positive margin, local recurrence and distant metastasis were important predictors for patients' prognosis.
Humans
;
Carcinoma, Adenoid Cystic/pathology*
;
Paranasal Sinus Neoplasms/pathology*
;
Retrospective Studies
;
Neoplasm Recurrence, Local/pathology*
;
Prognosis
4.Treatment and prognosis analysis of perineural invasion on sinonasal adenoid cystic carcinoma.
Ze Kun WANG ; Jiang Hu ZHANG ; Xue Song CHEN ; Qing Feng LIU ; Jing Bo WANG ; Run Yu WU ; Ye ZHANG ; Kai WANG ; Yuan QU ; Xiao Dong HUANG ; Jian Ping XIAO ; Li GAO ; Guo Zhen XU ; Jun Lin YI ; Jing Wei LUO
Chinese Journal of Oncology 2022;44(2):185-191
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
6.Radiologic Features of Nuclear Protein of the Testis Midline Carcinoma of the Nasal Cavity and Paranasal Sinuses:Report of One Case.
Xue-Ying HE ; Zhao-Hui LIU ; Qian ZHANG
Acta Academiae Medicinae Sinicae 2020;42(2):279-282
Nuclear protein of the testis midline carcinoma (NMC) is a rare malignant tumor that is mostly located in the upper trachea,mediastinal midline,and paravertebral midline,and few literature has described the imaging features of NMC in the nasal cavity and paranasal sinuses. In this article we summarize the clinical,radiologic,and pathologic data of one case of pathologically confirmed NMC in the nasal cavity and paranasal sinus by focusing on its CT and magnetic resonance imaging features.
Humans
;
Magnetic Resonance Imaging
;
Nasal Cavity
;
pathology
;
Nose Neoplasms
;
diagnostic imaging
;
Nuclear Proteins
;
Paranasal Sinus Neoplasms
;
diagnostic imaging
;
Paranasal Sinuses
;
pathology
;
Tomography, X-Ray Computed
9.One nursing case of nasal cavity paranasal sinus and maxillofacial huge myoepithelial carcinoma patient.
Dan ZHANG ; Min LUO ; Ying FENG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(18):1657-1658
A patient diagnosed with myoepithelial carcinoma was recently treated in our department. The neoplasm was huge, located in the left maxillofacial region, blocking both eyes, impeding feeding. About one month before admission, the tumor began to bleed frequently, about 100 ml each time, causing headache, dizziness, fatigue, and cold sweats. CT showed the maximum diameter of the tumor was about 23 cm, with uneven density, and maxillofacial bone destruction. MRI revealed internal bleeding and necrosis inside the tumor. After admission, blood routine test showed erythrocyte count 3.64 x 10(12)/L(↓), hemoglobin 106 g/L(↓), hematocrit 0.320 (↓), serum iron 6.2 μmol/L(↓). After surgery, the patient recovered smoothly.
Carcinoma
;
diagnosis
;
surgery
;
Humans
;
Magnetic Resonance Imaging
;
Myoepithelioma
;
diagnosis
;
surgery
;
Nasal Cavity
;
pathology
;
Paranasal Sinus Neoplasms
;
diagnosis
;
surgery
;
Paranasal Sinuses
;
pathology
10.Clinical analysis of imflammatory myofibroblastic tumor of the nasal cavity and paranasal sinus.
Qingjia GU ; Jiangang FAN ; Jingxian LI ; Debing LI ; Libing ZHAO ; Gang HE ; Linhong SONG ; Shenqing WANG ; Shuihong ZHOU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(19):1739-1742
OBJECTIVE:
To investigate the clinical features, therapeutic methods and therapeutic efficacy of imflammatory myofibroblastic tumor(IMT)of the nasal cavity and paranasal sinuses.
METHOD:
Clinical data of 14 cases diagnosed as IMT by pathology were retrospectively analyzed. There were 8 males and 6 females,age ranging from 18 to 77 years. 12 cases of them were treated by surgery while 2 cases received postoperative radiotherapy.
RESULT:
All cases were operated. All the patients were followed up for a period of 1 to 7 years after operation and two cases were proved low grade IMT pathologically. Eight cases survived with no recurrence until the last follow-up and 6 cases relapsed, of which 4 cases died and 2 were alive with tumor.
CONCLUSION
IMT of the nasal cavity and paranasal sinuses is very rare. The diagonosis of IMT is based on pathology and immunohistochemistry. Proper diagnosis is essential to avoid mutilating and disfiguring surgical procedures. Radical excision is still the first choice of treatment for IMT of the nasal cavity and paranasal sinuses. Chemotherapy and radiotherapy may not be helpful to prevent recurrence after operation. Due to high recurrence rate, long-term follow up is necessary after operation.
Adolescent
;
Adult
;
Aged
;
Female
;
Humans
;
Immunohistochemistry
;
Male
;
Middle Aged
;
Nasal Cavity
;
pathology
;
Neoplasm Recurrence, Local
;
Neoplasms, Muscle Tissue
;
pathology
;
radiotherapy
;
surgery
;
Paranasal Sinus Neoplasms
;
pathology
;
radiotherapy
;
surgery
;
Paranasal Sinuses
;
pathology
;
Retrospective Studies
;
Young Adult

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