Download PDF
J Neurol Surg B Skull Base 2016; 77(06): 456-465
DOI: 10.1055/s-0036-1582432
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Sinonasal Carcinomas with Neuroendocrine Features: Histopathological Differentiation and Treatment Outcomes

Liuba Soldatova
1   Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
,
Raewyn G. Campbell
1   Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
,
Ricardo L. Carrau
1   Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
2   Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
,
Daniel M. Prevedello
1   Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
2   Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
,
Paul Wakely Jr.
3   Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
,
Bradley A. Otto
1   Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
2   Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
,
Leo F. Ditzel Filho
1   Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
› Author Affiliations
Further Information

Publication History

29 January 2016

26 February 2016

Publication Date:
26 April 2016 (online)

   Permissions and Reprints

Abstract

Objectives Sinonasal cancers with neuroendocrine features share similar clinical, radiological, and histopathological features; however, these tumors often exhibit varying degrees of aggressive behavior presenting significant treatment challenges. The objective of this study was to report our experience with these rare malignancies and to present a review of current literature.

Methods Following institutional review board approval, the records of all patients with biopsy-proven sinonasal malignancies over a 5-year period were reviewed.

Results The study included 14 patients with olfactory neuroblastomas (ONBs), 7 patients with sinonasal undifferentiated carcinomas (SNUC), and 2 patients with sinonasal neuroendocrine carcinomas (SNEC). Histopathologic markers aided in final diagnosis, but showed variable specificity. In patients with sufficient follow-up, the 2-year disease-free survival rate was 81% (9/11) for ONB and 75% (3/4) for SNUC. Three patients developed a regional or distant recurrence (two with ONBs and one with SNUC). Two patients, one with SNEC and one with ONB, succumbed to brain radionecrosis related to proton radiation therapy.

Conclusions Overlapping clinical and histopathological features in poorly differentiated sinonasal cancers with neuroendocrine features continue to present a diagnostic challenge. Individualized assessment and treatment strategies can improve the accuracy of the initial assessment and the treatment outcomes.

Keywords

olfactory neuroblastoma - esthesioneuroblastoma - sinonasal undifferentiated carcinoma - sinonasal neuroendocrine carcinoma - sinonasal small cell cancer - sinonasal carcinoid - sinonasal large cell cancer - sinonasal cancers with neuroendocrine features - sinonasal cancers of neuroectodermal origin
 

  • References

  • 1 Bell D, Hanna EY, Weber RS , et al. Neuroendocrine neoplasms of the sinonasal region. Head Neck 2015; (e-pub ahead of print). doi: 10.1002/hed.24152
    PubMedGoogle Scholar
  • 2 Perez-Ordonez B. Neuroendocrine tumors. In: Barnes L, Eveson JW, Reichart P, Sidransky D, eds. Pathology and Genetics of Head and Neck Tumours. World Health Organization Classification of Tumours. Vol 9. Lyon, France: IARC Press; 2005: 26-27
    Google Scholar
  • 3 Xu B, Chetty R, Perez-Ordoñez B. Neuroendocrine neoplasms of the head and neck: some suggestions for the new WHO classification of head and neck tumors. Head Neck Pathol 2014; 8 (1) 24-32
    CrossrefPubMedGoogle Scholar
  • 4 van der Laan TP, Bij HP, van Hemel BM , et al. The importance of multimodality therapy in the treatment of sinonasal neuroendocrine carcinoma. Eur Arch Otorhinolaryngol 2013; 270 (9) 2565-2568
    CrossrefPubMedGoogle Scholar
  • 5 Mills SE. Neuroectodermal neoplasms of the head and neck with emphasis on neuroendocrine carcinomas. Mod Pathol 2002; 15 (3) 264-278 Review
    CrossrefPubMedGoogle Scholar
  • 6 Rosenthal DI, Barker Jr JL, El-Naggar AK , et al. Sinonasal malignancies with neuroendocrine differentiation: patterns of failure according to histologic phenotype. Cancer 2004; 101 (11) 2567-2573
    CrossrefPubMedGoogle Scholar
  • 7 Su SY, Bell D, Hanna EY. Esthesioneuroblastoma, neuroendocrine carcinoma, and sinonasal undifferentiated carcinoma: differentiation in diagnosis and treatment. Int Arch Otorhinolaryngol 2014; 18 (Suppl. 02) S149-S156
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Iezzoni JC, Mills SE. “Undifferentiated” small round cell tumors of the sinonasal tract: differential diagnosis update. Am J Clin Pathol 2005; 124 (Suppl): S110-S121
    PubMedGoogle Scholar
  • 9 Ow TJ, Bell D, Kupferman ME, Demonte F, Hanna EY. Esthesioneuroblastoma. Neurosurg Clin N Am 2013; 24 (1) 51-65
    CrossrefPubMedGoogle Scholar
  • 10 Faragalla H, Weinreb I. Olfactory neuroblastoma: a review and update. Adv Anat Pathol 2009; 16 (5) 322-331
    CrossrefPubMedGoogle Scholar
  • 11 Frierson Jr HF, Mills SE, Fechner RE, Taxy JB, Levine PA. Sinonasal undifferentiated carcinoma. An aggressive neoplasm derived from schneiderian epithelium and distinct from olfactory neuroblastoma. Am J Surg Pathol 1986; 10 (11) 771-779
    CrossrefPubMedGoogle Scholar
  • 12 Ejaz A, Wenig BM. Sinonasal undifferentiated carcinoma: clinical and pathologic features and a discussion on classification, cellular differentiation, and differential diagnosis. Adv Anat Pathol 2005; 12 (3) 134-143
    CrossrefPubMedGoogle Scholar
  • 13 Cerilli LA, Holst VA, Brandwein MS, Stoler MH, Mills SE. Sinonasal undifferentiated carcinoma: immunohistochemical profile and lack of EBV association. Am J Surg Pathol 2001; 25 (2) 156-163
    CrossrefPubMedGoogle Scholar
  • 14 Smith SR, Som P, Fahmy A, Lawson W, Sacks S, Brandwein M. A clinicopathological study of sinonasal neuroendocrine carcinoma and sinonasal undifferentiated carcinoma. Laryngoscope 2000; 110 (10 Pt 1): 1617-1622
    CrossrefPubMedGoogle Scholar
  • 15 Stelow EB, Bellizzi AM, Taneja K , et al. NUT rearrangement in undifferentiated carcinomas of the upper aerodigestive tract. Am J Surg Pathol 2008; 32 (6) 828-834
    CrossrefPubMedGoogle Scholar
  • 16 Rischin D, Coleman A. Sinonasal malignancies of neuroendocrine origin. Hematol Oncol Clin North Am 2008; 22 (6) 1297-1316 , xi
    CrossrefPubMedGoogle Scholar
  • 17 Montone KT. The differential diagnosis of sinonasal/nasopharyngeal neuroendocrine/neuroectodermally derived tumors. Arch Pathol Lab Med 2015; 139 (12) 1498-1507
    CrossrefPubMedGoogle Scholar
  • 18 Ordóñez NG. Value of SOX10 immunostaining in tumor diagnosis. Adv Anat Pathol 2013; 20 (4) 275-283
    CrossrefPubMedGoogle Scholar
  • 19 Miettinen M, McCue PA, Sarlomo-Rikala M , et al. Sox10—a marker for not only schwannian and melanocytic neoplasms but also myoepithelial cell tumors of soft tissue: a systematic analysis of 5134 tumors. Am J Surg Pathol 2015; 39 (6) 826-835
    CrossrefPubMedGoogle Scholar
  • 20 Dulguerov P, Allal AS, Calcaterra TC. Esthesioneuroblastoma: a meta-analysis and review. Lancet Oncol 2001; 2 (11) 683-690
    CrossrefPubMedGoogle Scholar
  • 21 Ingeholm P, Theilgaard SA, Buchwald C, Hansen HS, Francis D. Esthesioneuroblastoma: a Danish clinicopathological study of 40 consecutive cases. APMIS 2002; 110 (9) 639-645
    CrossrefPubMedGoogle Scholar
  • 22 Jethanamest D, Morris LG, Sikora AG, Kutler DI. Esthesioneuroblastoma: a population-based analysis of survival and prognostic factors. Arch Otolaryngol Head Neck Surg 2007; 133 (3) 276-280
    CrossrefPubMedGoogle Scholar
  • 23 Gruber G, Laedrach K, Baumert B, Caversaccio M, Raveh J, Greiner R. Esthesioneuroblastoma: irradiation alone and surgery alone are not enough. Int J Radiat Oncol Biol Phys 2002; 54 (2) 486-491
    CrossrefPubMedGoogle Scholar
  • 24 Chao KS, Kaplan C, Simpson JR , et al. Esthesioneuroblastoma: the impact of treatment modality. Head Neck 2001; 23 (9) 749-757
    CrossrefPubMedGoogle Scholar
  • 25 Ozsahin M, Gruber G, Olszyk O , et al. Outcome and prognostic factors in olfactory neuroblastoma: a rare cancer network study. Int J Radiat Oncol Biol Phys 2010; 78 (4) 992-997
    CrossrefPubMedGoogle Scholar
  • 26 Devaiah AK, Andreoli MT. Treatment of esthesioneuroblastoma: a 16-year meta-analysis of 361 patients. Laryngoscope 2009; 119 (7) 1412-1416
    CrossrefPubMedGoogle Scholar
  • 27 Ow TJ, Hanna EY, Roberts DB , et al. Optimization of long-term outcomes for patients with esthesioneuroblastoma. Head Neck 2014; 36 (4) 524-530
    CrossrefPubMedGoogle Scholar
  • 28 Zafereo ME, Fakhri S, Prayson R , et al. Esthesioneuroblastoma: 25-year experience at a single institution. Otolaryngol Head Neck Surg 2008; 138 (4) 452-458
    CrossrefPubMedGoogle Scholar
  • 29 Dave SP, Bared A, Casiano RR. Surgical outcomes and safety of transnasal endoscopic resection for anterior skull tumors. Otolaryngol Head Neck Surg 2007; 136 (6) 920-927
    CrossrefPubMedGoogle Scholar
  • 30 Liu JK, O'Neill B, Orlandi RR, Moscatello AL, Jensen RL, Couldwell WT. Endoscopic-assisted craniofacial resection of esthesioneuroblastoma: minimizing facial incisions—technical note and report of 3 cases. Minim Invasive Neurosurg 2003; 46 (5) 310-315
    Article in Thieme ConnectPubMedGoogle Scholar
  • 31 Podboj J, Smid L. Endoscopic surgery with curative intent for malignant tumors of the nose and paranasal sinuses. Eur J Surg Oncol 2007; 33 (9) 1081-1086
    CrossrefPubMedGoogle Scholar
  • 32 Poetker DM, Toohill RJ, Loehrl TA, Smith TL. Endoscopic management of sinonasal tumors: a preliminary report. Am J Rhinol 2005; 19 (3) 307-315
    PubMedGoogle Scholar
  • 33 Suriano M, De Vincentiis M, Colli A, Benfari G, Mascelli A, Gallo A. Endoscopic treatment of esthesioneuroblastoma: a minimally invasive approach combined with radiation therapy. Otolaryngol Head Neck Surg 2007; 136 (1) 104-107
    CrossrefPubMedGoogle Scholar
  • 34 Unger F, Haselsberger K, Walch C, Stammberger H, Papaefthymiou G. Combined endoscopic surgery and radiosurgery as treatment modality for olfactory neuroblastoma (esthesioneuroblastoma). Acta Neurochir (Wien) 2005; 147 (6) 595-601 , discussion 601–602
    CrossrefPubMedGoogle Scholar
  • 35 Castelnuovo PG, Delù G, Sberze F , et al. Esthesioneuroblastoma: endonasal endoscopic treatment. Skull Base 2006; 16 (1) 25-30
    Article in Thieme ConnectPubMedGoogle Scholar
  • 36 Lund V, Howard DJ, Wei WI. Endoscopic resection of malignant tumors of the nose and sinuses. Am J Rhinol 2007; 21 (1) 89-94
    CrossrefPubMedGoogle Scholar
  • 37 Nicolai P, Battaglia P, Bignami M , et al. Endoscopic surgery for malignant tumors of the sinonasal tract and adjacent skull base: a 10-year experience. Am J Rhinol 2008; 22 (3) 308-316
    CrossrefPubMedGoogle Scholar
  • 38 Folbe A, Herzallah I, Duvvuri U , et al. Endoscopic endonasal resection of esthesioneuroblastoma: a multicenter study. Am J Rhinol Allergy 2009; 23 (1) 91-94
    CrossrefPubMedGoogle Scholar
  • 39 De Bonnecaze G, Chaput B, Al Hawat A , et al. Long-term oncological outcome after endoscopic surgery for olfactory esthesioneuroblastoma. Acta Otolaryngol 2014; 134 (12) 1259-1264
    CrossrefPubMedGoogle Scholar
  • 40 Howard DJ, Lund VJ, Wei WI. Craniofacial resection for tumors of the nasal cavity and paranasal sinuses: a 25-year experience. Head Neck 2006; 28 (10) 867-873
    CrossrefPubMedGoogle Scholar
  • 41 Polin RS, Sheehan JP, Chenelle AG , et al. The role of preoperative adjuvant treatment in the management of esthesioneuroblastoma: the University of Virginia experience. Neurosurgery 1998; 42 (5) 1029-1037
    CrossrefPubMedGoogle Scholar
  • 42 Beitler JJ, Fass DE, Brenner HA , et al. Esthesioneuroblastoma: is there a role for elective neck treatment?. Head Neck 1991; 13 (4) 321-326
    CrossrefPubMedGoogle Scholar
  • 43 Monroe AT, Hinerman RW, Amdur RJ, Morris CG, Mendenhall WM. Radiation therapy for esthesioneuroblastoma: rationale for elective neck irradiation. Head Neck 2003; 25 (7) 529-534
    CrossrefPubMedGoogle Scholar
  • 44 Diaz Jr EM, Johnigan III RH, Pero C , et al. Olfactory neuroblastoma: the 22-year experience at one comprehensive cancer center. Head Neck 2005; 27 (2) 138-149
    CrossrefPubMedGoogle Scholar
  • 45 Loy AH, Reibel JF, Read PW , et al. Esthesioneuroblastoma: continued follow-up of a single institution's experience. Arch Otolaryngol Head Neck Surg 2006; 132 (2) 134-138
    CrossrefPubMedGoogle Scholar
  • 46 Lund VJ, Howard DJ, Wei WI, Cheesman AD. Craniofacial resection for tumors of the nasal cavity and paranasal sinuses—a 17-year experience. Head Neck 1998; 20 (2) 97-105
    CrossrefPubMedGoogle Scholar
  • 47 Zanation AM, Ferlito A, Rinaldo A , et al. When, how and why to treat the neck in patients with esthesioneuroblastoma: a review. Eur Arch Otorhinolaryngol 2010; 267 (11) 1667-1671
    CrossrefPubMedGoogle Scholar
  • 48 Noh OK, Lee SW, Yoon SM , et al. Radiotherapy for esthesioneuroblastoma: is elective nodal irradiation warranted in the multimodality treatment approach?. Int J Radiat Oncol Biol Phys 2011; 79 (2) 443-449
    CrossrefPubMedGoogle Scholar
  • 49 Musy PY, Reibel JF, Levine PA. Sinonasal undifferentiated carcinoma: the search for a better outcome. Laryngoscope 2002; 112 (8 Pt 1): 1450-1455
    CrossrefPubMedGoogle Scholar
  • 50 Al-Mamgani A, van Rooij P, Mehilal R, Tans L, Levendag PC. Combined-modality treatment improved outcome in sinonasal undifferentiated carcinoma: single-institutional experience of 21 patients and review of the literature. Eur Arch Otorhinolaryngol 2013; 270 (1) 293-299
    CrossrefPubMedGoogle Scholar
  • 51 Tanzler ED, Morris CG, Orlando CA, Werning JW, Mendenhall WM. Management of sinonasal undifferentiated carcinoma. Head Neck 2008; 30 (5) 595-599
    CrossrefPubMedGoogle Scholar
  • 52 Chen AM, Daly ME, El-Sayed I , et al. Patterns of failure after combined-modality approaches incorporating radiotherapy for sinonasal undifferentiated carcinoma of the head and neck. Int J Radiat Oncol Biol Phys 2008; 70 (2) 338-343
    CrossrefPubMedGoogle Scholar
  • 53 Miyamoto RC, Gleich LL, Biddinger PW, Gluckman JL. Esthesioneuroblastoma and sinonasal undifferentiated carcinoma: impact of histological grading and clinical staging on survival and prognosis. Laryngoscope 2000; 110 (8) 1262-1265
    CrossrefPubMedGoogle Scholar
  • 54 Perez-Ordonez B, Caruana SM, Huvos AG, Shah JP. Small cell neuroendocrine carcinoma of the nasal cavity and paranasal sinuses. Hum Pathol 1998; 29 (8) 826-832
    CrossrefPubMedGoogle Scholar
  • 55 Reiersen DA, Pahilan ME, Devaiah AK. Meta-analysis of treatment outcomes for sinonasal undifferentiated carcinoma. Otolaryngol Head Neck Surg 2012; 147 (1) 7-14
    CrossrefPubMedGoogle Scholar
  • 56 Revenaugh PC, Seth R, Pavlovich JB, Knott PD, Batra PS. Minimally invasive endoscopic resection of sinonasal undifferentiated carcinoma. Am J Otolaryngol 2011; 32 (6) 464-469
    CrossrefPubMedGoogle Scholar
  • 57 Fitzek MM, Thornton AF, Varvares M , et al. Neuroendocrine tumors of the sinonasal tract. Results of a prospective study incorporating chemotherapy, surgery, and combined proton-photon radiotherapy. Cancer 2002; 94 (10) 2623-2634
    CrossrefPubMedGoogle Scholar
  • 58 Babin E, Rouleau V, Vedrine PO , et al. Small cell neuroendocrine carcinoma of the nasal cavity and paranasal sinuses. J Laryngol Otol 2006; 120 (4) 289-297
    PubMedGoogle Scholar
  • 59 Mitchell EH, Diaz A, Yilmaz T , et al. Multimodality treatment for sinonasal neuroendocrine carcinoma. Head Neck 2012; 34 (10) 1372-1376
    CrossrefPubMedGoogle Scholar
  • 60 Deutsch BD, Levine PA, Stewart FM, Frierson Jr HF, Cantrell RW. Sinonasal undifferentiated carcinoma: a ray of hope. Otolaryngol Head Neck Surg 1993; 108 (6) 697-700
    CrossrefPubMedGoogle Scholar
  • 61 Gallo O, Graziani P, Fini-Storchi O. Undifferentiated carcinoma of the nose and paranasal sinuses. An immunohistochemical and clinical study. Ear Nose Throat J 1993; 72 (9) 588-590 , 593–595
    PubMedGoogle Scholar
  • 62 Levine PA, Frierson Jr HF, Stewart FM, Mills SE, Fechner RE, Cantrell RW. Sinonasal undifferentiated carcinoma: a distinctive and highly aggressive neoplasm. Laryngoscope 1987; 97 (8 Pt 1): 905-908
    PubMedGoogle Scholar
  • 63 Haas I, Ganzer U. Does sophisticated diagnostic workup on neuroectodermal tumors have an impact on the treatment of esthesioneuroblastoma?. Onkologie 2003; 26 (3) 261-267
    CrossrefPubMedGoogle Scholar