RESUMO
BACKGROUND: Squamous cell carcinoma (SCC) of the sinonasal cavity is a rare entity that arises as either de-novo tumors or from inverted papillomas (IPs). In this study we evaluate and compare oncologic outcomes of sinonasal SCCs based on their etiology and treatment strategy. METHODS: This investigation was a single-center, retrospective review comparing de-novo SCCs (n = 28) and those associated with IPs (n = 38) resected during the period from 2000 to 2015. Demographic and tumor data, surgical approach, recurrence, and clinical outcomes were analyzed. RESULTS: There was no statistical difference when comparing age, smoking history, tumor origin, or tumor stage of our patients with de-novo sinonasal SCC (DN-SCC) vs IP-transformed SCC (IP-SCC). IP-SCC tumors demonstrated better overall survival (p = 0.065) and disease-specific survival (p = 0.041) compared with DN-SCC. Early T-stage IP-SCC tumors had better disease-free survival compared with early T-stage DN-SCC tumors (p = 0.002). Distant metastasis was an independent prognostic factor of worse disease-specific survival (p = 0.002). SCC disease-specific survival was not affected by surgical resection technique. CONCLUSION: SCC tumors arising from IPs appear to have improved disease-specific survival compared with de-novo sinonasal SCC tumors. The oncologic differences between the 2 groups are found primarily among the early-stage tumors.
Assuntos
Carcinoma de Células Escamosas/etiologia , Neoplasias dos Seios Paranasais/etiologia , Idoso , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Intervalo Livre de Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/etiologia , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/terapia , Estadiamento de Neoplasias , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/terapia , Prognóstico , Modelos de Riscos Proporcionais , Resultado do TratamentoAssuntos
Poluição do Ar/efeitos adversos , Linfoma não Hodgkin/etiologia , Cavidade Nasal , Neoplasias Nasais/etiologia , Neoplasias dos Seios Paranasais/etiologia , Humanos , Incidência , Linfoma não Hodgkin/epidemiologia , México/epidemiologia , Neoplasias Nasais/epidemiologia , Neoplasias dos Seios Paranasais/epidemiologia , Vigilância da População , Fatores de RiscoRESUMO
Air pollution is a serious health problem in major cities in Mexico. The concentrations of monitored criteria pollutants have been above the US National Ambient Air Quality Standards for the last decade. To determine whether the number of primary malignant nasal and paranasal neoplasms has increased, we surveyed 256 such cases admitted to a major adult oncology hospital located in metropolitan Mexico City (MMC) for the period from 1976-1997 and to a tertiary hospital in Monterrey, an industrial city, for the period from 1993-1998. The clinical histories and histopathologic material were reviewed, and a brief clinical summary was written for each case. In the MMC hospital the number of newly diagnosed nasal and paranasal neoplasms per year for the period from 1976-1986 averaged 5.1, whereas for the next 11 years it increased to 12.5. The maximal increase was observed in 1995-1997, with an average of 20.3 new cases per year (P = 0.0006). The predominant neoplasms in these series were non-Hodgkin's lymphoma, squamous cell carcinoma, melanoma, adenocarcinoma, Schneiderian carcinoma, and nasopharyngeal carcinoma. In the Monterrey hospital a 2-fold increase in the numbers of newly diagnosed nasal and paranasal neoplasms was recorded between 1993 and 1998. The predominant MMC neoplasm in this series, namely nasal T-cell/natural killer cell non-Hodgkin's lymphoma, is potentially Epstein-Barr virus related. Nasal and paranasal malignant neoplasms are generally rare. Environmental causative factors include exposure in industries such as nickel refining, leather, and wood furniture manufacturing. Although epidemiologic studies have not addressed the relationship between outdoor air pollution and sinonasal malignant neoplasms, there is strong evidence for the nasal and paranasal carcinogenic effect of occupational aerosol complex chemical mixtures. General practitioners and ear, nose, and throat physicians working in highly polluted cities should be aware of the clinical presentations of these patients. Identification of this apparent increase in sinonasal malignant neoplasms in two urban Mexican polluted cities warrants further mechanistic and epidemiologic studies.
Assuntos
Poluição do Ar/efeitos adversos , Cavidade Nasal , Neoplasias Nasais/epidemiologia , Neoplasias dos Seios Paranasais/epidemiologia , Adenocarcinoma/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , California/epidemiologia , Carcinoma/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células de Transição/epidemiologia , Feminino , Humanos , Linfoma não Hodgkin/epidemiologia , Masculino , Melanoma/epidemiologia , México/epidemiologia , Pessoa de Meia-Idade , Neoplasias Nasais/etiologia , Exposição Ocupacional , Neoplasias dos Seios Paranasais/etiologiaRESUMO
En el presente trabajo el autor describe la frecuencia de presentación de estos tumores. Así mísmos hace un resumen de las características de anatomía patológica que presentan los tumores de esta región, así como su comportamiento. También hace mensión de la sintomatología principal en este tipo de enfermedades. Esboza también las conductas de diagnótico y el pronóstico para este tipo de tumores. Por último plantea las opciones de tratamiento que se pueden dar en este tipo de afecciones.
The author details the frequency of growth of these kinds of tumors. He summarizes the characteristics of pathological anatomy which these tumours have in this region and their devolopment. The main symptomatology in these kinds of diseases is also described. He outlines the prognostic and diagnostic of these kinds of tumours. Finally he proposes some treatment choice for the affections in mentioned above.
Assuntos
Masculino , Feminino , Humanos , Neoplasias dos Seios Paranasais , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/etiologia , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/terapia , Seios Paranasais , Seios Paranasais/patologiaRESUMO
A 71-year-old woman developed complete third nerve palsy and total blindness of the right eye one month after completing a course of radiotherapy for sphenoid sinus carcinoma over a 13-month period. Differential diagnosis included recurrence of the tumor, radiation-induced second neoplasm, empty sella with chiasmal prolapse and secondary chiasmal arachnoid adhesions, and radionecrosis. Magnetic resonance imaging demonstrated gadolinium contrast enhancement of the right intracranial optic nerve and chiasm, suggesting a radionecrosis process.