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Review
. 2023 Jan;73(1):72-112.
doi: 10.3322/caac.21752. Epub 2022 Aug 2.

The contemporary management of cancers of the sinonasal tract in adults

Rajat Thawani  1 , Myung Sun Kim  1 , Asad Arastu  2 , Zizhen Feng  1 , Malinda T West  1 , Nicholas F Taflin  2 , Kyaw Zin Thein  1 , Ryan Li  3 , Mathew Geltzeiler  3 , Nancy Lee  4 , Clifton David Fuller  5 , Jennifer R Grandis  6 , Charalampos S Floudas  7 , Michael C Heinrich  1 , Ehab Hanna  8 , Ravi A Chandra  9
Affiliations
Review

The contemporary management of cancers of the sinonasal tract in adults

Rajat Thawani et al. CA Cancer J Clin. 2023 Jan.

Abstract

Sinonasal malignancies make up <5% of all head and neck neoplasms, with an incidence of 0.5-1.0 per 100,000. The outcome of these rare malignancies has been poor, whereas significant progress has been made in the management of other cancers. The objective of the current review was to describe the incidence, causes, presentation, diagnosis, treatment, and recent developments of malignancies of the sinonasal tract. The diagnoses covered in this review included sinonasal undifferentiated carcinoma, sinonasal adenocarcinoma, sinonasal squamous cell carcinoma, and esthesioneuroblastoma, which are exclusive to the sinonasal tract. In addition, the authors covered malignances that are likely to be encountered in the sinonasal tract-primary mucosal melanoma, NUT (nuclear protein of the testis) carcinoma, and extranodal natural killer cell/T-cell lymphoma. For the purpose of keeping this review as concise and focused as possible, sarcomas and malignancies that can be classified as salivary gland neoplasms were excluded.

Keywords: head and neck neoplasms; paranasal sinus neoplasms; rare diseases; sinonasal carcinoma.

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Conflict of interest statement

Conflict of interest statement: Michael C Heinrich serves in a consultancy role for Blueprint Medicines, Deciphera Pharmaceuticals, and Novartis; receives royalties from Novartis; receives grant funding from Blueprint Medicines and Deciphera Pharmaceuticals.

Figures

Figure 1:
Figure 1:
H&E of Sinonasal Squamous Cell Carcinoma originating from an inverted papilloma
Figure 2:
Figure 2:
PET/CT of Sinonasal Squamous Cell Carcinoma originating from an inverted papilloma
Figure 3:
Figure 3:
Authors algorithm summarizing management of Sinonasal Squamous Cell Carcinoma
Figure 4:
Figure 4:
Authors algorithm summarizing management of Sinonasal Neuroendocrine Carcinoma
Figure 5:
Figure 5:
A. H&E stain of Sinonasal Undifferentiated Carcinoma showing undifferentiated cells B. Loss of INI-1 staining seen in Sinonasal Undifferentiated Carcinoma
Figure 6:
Figure 6:
MRI with local invasion of Sinonasal Undifferentiated Carcinoma
Figure 7:
Figure 7:
Algorithm summarizing management of Sinonasal Undifferentiated Carcinoma
Figure 8:
Figure 8:
H&E of sinonasal melanoma with sheets of tumor cells, many of them loaded with melanin pigment, as well as intermixed lymphocytes
Figure 9:
Figure 9:
FDG-PET showing axillary lymphadenopathy in a patient with primary mucosal melanoma after primary resection
Figure 10:
Figure 10:
Authors algorithm summarizing management of Primary Mucosal Melanoma
Figure 11:
Figure 11:
MRI and PET imaging of the brain in a patient with NUT midline carcinoma with brain invasion and retropharyngeal adenopathy.
Figure 12:
Figure 12:
H&E and different immunostains in a biopsy sample with NK/T Cell Lymphoma
Figure 13:
Figure 13:
MRI with nasal NK/T Cell Lymphoma
Figure 14:
Figure 14:
Algorithm summarizing management of NK/T Cell Lymphoma
Figure 15:
Figure 15:
Esthesioneuroblastoma histology in H&E with Hyams grade I, with Ki67 7%, with PHH3, synaptophysin, chromogranin and S100 positivity.
Figure 16:
Figure 16:
DOTATE PET and MRI in a patient with Esthesioneuroblastoma in the right nasal cavity mass with extension into the right ethmoid air cells and epidural intracranial involvement along the cribriform plate.
Figure 17:
Figure 17:
H&E of paraganglioma showing pink epitheloid cells with round hyperchromatic nucleus.
See this image and copyright information in PMC

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