A clinical analysis of sinonasal squamous cell carcinoma: a comparison of de novo squamous cell carcinoma and squamous cell carcinoma arising from inverted papilloma

Abstract

Background: Sinonasal squamous cell carcinoma (SCC) is a rare tumor arising either de novo or in association with inverted papillomas (IPs).

Objectives: The aim of this study was to investigate and compare the oncological features and prognosis of patients with sinonasal SCCs based on their etiology.

Material and methods: The medical records of 117 patients who had been diagnosed with de novo SCC or those arising from IP (IP-SCC) were retrospectively reviewed. In situ hybridization analyses to detect HPV 16/18DNA and p16 immunohistochemistry were also performed in 10 cases with IP-SCC.

Results: The three-year disease-specific survival (DSS) rate was higher in cases with T1, 2 and 3 than in cases with T4 in both tumor groups. T4 cases with de novo SCC had a better DSS than those with IP-SCCs. HPV16/18 was not detected in any of the 10 IP-SCCs.

Conclusions and significance: T4 cases with de novo SCC tended to have a better DSS than those with IP-SCC. Since some T4 patients with IP-SCC were found to have a highly aggressive disease, careful treatment planning should be performed. High-risk HPV may not play a vital role in the carcinomatous transformation of most IP-SCC cases.     

Sinonasal inverted papilloma associated with small cell neuroendocrine carcinoma: A case report and literature review of rare malignancies associated with inverted papilloma

We report a rare case of sinonasal inverted papilloma (IP) associated with small cell neuroendocrine carcinoma (SNEC). To our knowledge, this is the first report to describe SNEC found during the treatment of sinonasal IP. Surgery and five cycles of cisplatin plus etoposide with concurrent intensity modulated radiation therapy were performed. Neither local recurrence nor distant metastasis was noted during 6 years of post-diagnostic follow-up. The prognosis of SNEC is very poor. Treatment planning for sinonasal IP should consider a possible association with this rare but aggressive malignancy, whose treatment is completely different from that of squamous cell carcinoma, a malignancy which is commonly associated with IP.We also performed a PubMed review of the literature to identify the incidence and pathological diagnosis of associated malignancy. Among a total of 5286 cases of sinonasal IP (61 studies), the incidence of associated malignancy was 8.02% in squamous cell carcinoma, 0.19% in transitional cell carcinoma, 0.04% in mucoepidermoid carcinoma, 0.02% in verrucous cell carcinoma and 0.02% in adenocarcinoma. The incidence of associated malignancy was significantly higher in East and Southeast Asia (11.0%) and North America (10.4%) than in Europe (3.9%) (p = 0.04 and p = 0.03, respectively; T-test).     

Pediatric inverted papilloma of the middle ear: Case report and review of the literature

Inverted papilloma of middle ear is a very rare clinical entity. It has been reported only in the adult population. We report a middle ear inverted papilloma in an 11-year-old male. To the best of our knowledge it is the first pediatric inverted papilloma of middle ear. The patient had a history of chronic suppurative otitis media and the lesion was found during preoperative evaluation for a tympanoplasty procedure. Total excision of the lesion and a tympanoplasty operation was accomplished. We reviewed the middle ear inverted papilloma cases regarding the age distribution, pathophysiology, treatment and prognosis.     

Rising incidence of oropharyngeal cancer and the role of oncogenic human papilloma virus

OBJECTIVES/HYPOTHESIS: To document the increasing incidence of oropharyngeal (OP) cancer and to provide evidence that this increase is caused by oncogenic human papilloma virus (HPV). STUDY DESIGN: Epidemiologic review and retrospective case series analysis. METHODS: We collected data from Colorado and the United States comparing the average annual age-adjusted incidence rates of OP and non-OP head and neck cancer between the periods 1980 to 1990 and 1991 to 2001. We obtained data on 72 patients with OP cancer from a single county in Colorado, from 1980 through 2004. HPV status was determined by DNA-polymerase chain reaction. We assessed disease-specific survival. RESULTS: The average annual age-adjusted incidence of OP cancer in males in Colorado increased from 2.54 per 100,000 to 3.47 (P < .05) or 36.6%, whereas the U.S. rate increased from 4.34 to 4.81 (P < .05) or 10.8%. The rates in females and the rates of non-OP head and neck cancer decreased. Of the 72 cases, 50 (69%) were positive for HPV subtype 16. The ratio of HPV-positive to HPV-negative cases prior to 1995 was 0.72 (8:11) but was 3.81 (42:11) afterward. Survival was positively affected by HPV status (hazard ratio of 0.15, confidence intervals 0.07-0.36, P < .001). Disease-specific survival was 83% in the HPV-positive patients and 15% in the HPV-negative group. CONCLUSIONS: OP cancer incidence is increasing in Colorado males and to a lesser extent in U.S. males. The HPV-positive OP cancer cases were more frequent in the later years of the study. Disease-specific survival was much better in the HPV-positive patients, confirming that HPV testing defines a unique subset of patients. These findings suggest that HPV oncogenesis accounts for the increase in average annual age-adjusted incidence of OP cancer.     

Effect of human papilloma virus expression on clinical course of laryngeal papilloma

Conclusion. Our observations suggest that human papilloma virus (HPV) 6/11 is the main causative agent of laryngeal papilloma and that detection of active HPV DNA expression may be helpful in identifying patients with aggressive recurrent laryngeal papilloma. Objectives. HPV is assumed to be the main causative agent of this disease. We investigated the expression of the entire genotype of HPV in cases of laryngeal papilloma and correlated their expression with the clinical course of the disease. Subjects and methods. Seventy cases of laryngeal papilloma were evaluated for the presence of the HPV genome by in situ hybridization (ISH) using wide-spectrum HPV DNA probe. Specific types of HPV infection were determined by DNA ISH using type-specific HPV DNA probes (HPV 6, 11, 16, 18, 31, 33). Separate analyses were conducted comparing viral types, frequency of recurrences and duration of disease-free periods. Results. We detected HPV DNA in 40 of the 70 laryngeal papilloma cases (57%). In particular, HPV DNA was detected in 75% of the juvenile types. There were significant associations between HPV and laryngeal papilloma (p<0.01). Among the HPV-positive cases, major specific types were HPV 6/11 (97%). Significant associations were also noted between viral expression and clinical course.     

Etiology of sinonasal inverted papilloma: A narrative review

ObjectiveSinonasal inverted papilloma (IP) is a benign and uncommon tumor of the nasal cavity and paranasal sinuses with a tendency for recurrence and even malignant transformation. Though the morphology and clinical behavior of this lesion has been well described, its etiology remains controversial.MethodsComputerized searches were performed in PubMed, Scopus, and Google scholar through May 2015. In this review, etiologic factors including human papilloma virus (HPV), Epstein–Barr virus (EBV), cell cycle related proteins and angiogenic factors, occupational and environmental exposures, and chronic inflammation, will be discussed.ResultsMany studies indicate that HPV has been detected in a significant percentage of IP, while EBV has not been shown to be significantly associated. Certain cell cycle regulatory factors and angiogenic proteins contribute to the dysregulation of proliferation and apoptosis, and facilitate migration and tumor invasion. Occupational exposures, such as welding and organic solvents, have been implicated, and smoking seems more critical to recurrence and dysplasia rather than initial IP occurrence. Chronic inflammation may also have a causative relationship with inverted papilloma, but the mechanism is unclear.ConclusionsThough etiology of sinonasal IP remains controversial, the studies reviewed here indicate a role for viral infection, cell cycle and angiogenic factors, environmental and occupational exposure, and chronic inflammation. Further study on etiologic factors is necessary for clinical guidance and therapeutic targets.     

Inverted schneiderian papilloma of the supraglottis: Case report

Inverted schneiderian papillomas are rare benign tumors, most often arising from the sinonasal mucosa. We describe a case of a 59‐year‐old female with an inverted papilloma of the supraglottis. This is the first reported case of a supraglottic‐presenting inverted papilloma. Although rare, this case demonstrates that these tumors should be considered during workup of supraglottic laryngeal masses. Laryngoscope, 127:2830–2832, 2017     

Bilateral inverted papilloma of the middle ear with intracranial involvement and malignant transformation: first reported case

Inverted (Schneiderian) papilloma (IP) is a benign but locally aggressive tumor that is typically located in the sinonasal tract. Middle ear involvement and intracranial extension are rare. We present a patient with a history of a completely resected right nasal cavity IP that returned 7 months later with hearing loss, bilateral aural fullness, and right-sided facial weakness. Work-up revealed middle ear IP, and the patient underwent bilateral mastoidectomies. On both sides, the disease caused erosion of the tegmen and was adherent to the underlying dura. There was dehiscence of the carotid canal wall on the left. On the right, the tumor was discovered to have recurred 3 months after initial resection, resulting in complete facial nerve paralysis and trigeminal paresthesias. A right temporal bone resection was undertaken along with neurosurgery. The IP was discovered to have invaded through the dura of the temporal lobe, incase the internal carotid artery, and infiltrate the trigeminal nerve. The facial and vestibulocochlear nerves were sacrificed on the right. Pathology of the right temporal bone revealed malignant transformation to squamous carcinoma. The patient was referred to radiation oncology for postoperative therapy. To our knowledge, this is the first case of bilateral IP of the middle ear with intracranial involvement and malignant transformation. Discussion points include: 1) management of middle ear IP, 2) carotid canal wall dehiscence in erosive middle ear disease, 3) aggressive surgical excision in locally destructive middle ear tumors, and 4) the role of radiation therapy in malignant transformation of IP.     

Clinical report: cylindrical cell papilloma of the paranasal sinus

Summary We report a case of cylindrical cell papilloma of the paranasal sinuses. This tumor originated in the medial wall of the left maxillary sinus of a 69-year-old man and extended to the surrounding tissues. Pathological study of tissue sections from the tumor showed typical findings of cylindrical cell papilloma with no evidence of associated malignancy. Histochemical and electron microscopic examinations revealed a large number of mitochondria in the cytoplasm of the tumor cells. The tumor was removed through a Denker's approach. The patient did well following surgery and there has been no sign of recurrence in a 2-year follow-up study.     

Squamous papillomas of the larynx in adults. A review of 63 cases

Sixty-three cases of squamous papillomas of the larynx occurring in adults are presented. Twelve cases started as juvenile papillomas and continued into adult life. Twice as many males as females were in the series. The papillomas were always present on the true vocal cords at presentation, although other parts of the larynx were involved to a variable extent. The symptom of hoarseness gave a good indication as to the state of the larynx during treatment. Malignancy did not develop in patients with papillomas which fulfilled the histological criteria. Papillomas are clusters of thin, cylindrical projections of squamous epithelial covered mucosa with second and even third order branching. Biopsies in 5 cases show papillomatosis of respiratory epithelium, a process which is here described in the larynx for the first time. The prognosis as regards recurrence for 20 patients with solitary lesions was good, for 38 patients with multiple lesions reasonable, but for 5 patients with extensive florid lesions was exceptionally poor.     

鳃裂癌一例报告并文献复习

正鳃裂癌是原发于鳃裂残迹的恶性肿瘤,以鳞状上皮癌为主要病理类型。发病率很低,目前文献报道多为个案。现结合广东省中医院大学城医院耳鼻喉科收治1例鳃裂癌患者的病历资料,并复习相关文献,总结鳃裂癌的诊断要点,重点讨论鳃裂癌的治疗方法,报道如下。1资料与方法.1一般资料患者男,61岁,2014年10月发现     

Inverted papilloma of the middle ear: a case report and review of the literature

Papilloma of the middle ear is extremely rare; to our knowledge there have been only 9 reports (13 cases) in the literature. Aggressive surgical excision is the only curative treatment and radiation therapy is necessary if there is evidence of focal squamous cell carcinoma. We describe a case of a 65-year-old male with inverted papilloma of the middle ear. The tumor was surgically resected by radical tympanomastoidectomy, and we provided postoperative radiation therapy. There has been no evidence of recurrence to date. We discuss the clinical presentation, diagnosis, and treatment of this case and present a review of the literature.     

喉部乳头状鳞状细胞癌的临床病理特征分析--附1例报告及文献复习

目的 结合文献探讨喉部乳头状鳞状细胞癌即疣性癌的临床病理特征。方法 报道1例喉部乳头状鳞状细胞癌，就本病的临床生物学特征、病理、诊断、治疗及预后进行分析。结果 经手术及放疗后半年复查，肿瘤未复发。结论 喉部乳头状鳞状细胞癌是低度恶性肿瘤，临床因其病理特征而较难确诊，要求深部取材活检和HPV检查，治疗以手术切除加颈淋巴结清扫为主，术后可追加放疗。     

Inverting papilloma of the temporal bone.

OBJECTIVES: Inverting papilloma of the temporal bone is exceedingly rare. The objective is to familiarize the clinician with the clinical presentation and prognosis of this entity. STUDY DESIGN: Retrospective case study and literature review. METHODS: Published reports of inverting papillomas originating in the temporal bone were reviewed in conjunction with two cases presenting at the University of Texas Medical Branch (Galveston, TX). RESULTS: Inverting papillomas of the temporal bone are frequently associated with persistent middle ear effusion and ipsilateral sinonasal tumors and display a higher incidence of malignancy. CONCLUSIONS: Successful management of these tumors requires an aggressive surgical resection. Adjuvant radiation therapy is recommended in patients with malignant changes.     

鼻腔鼻窦内翻性乳头状瘤恶变鳞状细胞癌中HPV的分布及预后分析

目的检测人类乳头状瘤病毒（ human papillomavirus, HPV）在鼻腔鼻窦内翻性乳头状瘤恶变鳞状细胞癌（squamous cell carcinoma arising from sinonasal inverted papilloma,SCC/IP）中的感染分布,分析两者的预后关系。方法回顾性分析1997年1月~2012年1月符合入组条件的SCC/IP患者共55例,利用“三明治”方法检测其标本HPV的感染状态,采用Kaplan Meier生存分析法研究患者总生存率和疾病特异性生存率,采用Log rank检测进行单因素分析,采用Cox模型进行多因素分析,计数资料之间采用卡方检验。结果HPV感染11例,感染比例为20%(11/55),其中HPV 16型5例,HPV 6型3例,HPV 39型、HPV 18/39型和HPV 33/52/54型各1例。5年总生存率为35.6%,HPV阳性组为18.7%,HPV阴性组为38.9%;5年疾病特异性生存率为42.7%,HPV阳性组为18.7%,HPV阴性组为49.2%。HPV阳性组总体生存率和疾病特异性生存率与HPV阴性组比较,差异无统计学意义(P=0.915,P=0.773), Cox模型分析示HPV状态对总体生存率及疾病特异性生存率亦无影响（P=0.553, P=0.976）。结论SCC/IP中HPV感染率为20%,HPV感染状态对SCC/IP的预后没有影响。     

中西医结合治疗小儿喉尖锐湿疣,喉乳头状瘤疗效分析

1991年1月～1995年4月间对8例喉尖锐湿疣、6例喉乳头状瘤患儿施行手术、激光、干扰素等综合治疗,除1例治愈外,其余皆复发,治愈率7．1％。1995年6月开始,对上述复发患儿及另3例喉尖锐湿疣和喉乳头状瘤患儿进行中西医结合治疗,随访2～25年无复发,治愈率86．67％。治疗前后进行嗓音电脑分析,各项指标P值均小于0．01。因此认为：中西医结合治疗具有手术范围小、种植机会少、复发率低、手术出数少、费用低、音质恢复良好等优点,并指出治疗及方剂中的要点和注意事项。