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Ohta N, Noguchi N, Shinohara S, Murakami K, Nakazumi M, Suzuki T, Sato T, Ise K, Kagaya Y, Tamura R, Murakami K, Nakamura Y. Endoscopic Treatment of Sinonasal Leiomyosarcoma: A Case Report in Light of the Literature. Yonago Acta Med 2021; 64:217-221. [PMID: 34025199 DOI: 10.33160/yam.2021.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/02/2021] [Indexed: 02/05/2023]
Abstract
A 49-year-old Japanese man presented with a rare case of sinonasal leiomyosarcoma with left nasal bleeding for 12 months. He had no history of irradiation or malignancies, including retinoblastoma. Preoperative histological examination suggested vascular leiomyoma. Complete resection with endoscopic surgery was performed. Histological examination during the operation suggested that the tumor was a leiomyoma. However, immunohistochemical staining for α smooth muscle actin and desmin were helpful in establishing a definitive diagnosis of sinonasal leiomyosarcoma. The resection margins were positive for tumor cells. Staging with CT of the neck and thorax, ultrasound of the abdomen, and MRI of the head ruled out metastases. Second endoscopic tumor resection surgery was performed for positive resection margins. The patient's condition was successfully managed with additional excision, and he remains well with no evidence of recurrence and metastasis 36 months after treatment. Endoscopic management should be considered in suitable cases.
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Affiliation(s)
- Nobuo Ohta
- Division of Otolaryngology, Tohoku Medical and Pharmaceutical University, Sendai 981-8536, Japan
| | - Naoya Noguchi
- Division of Otolaryngology, Tohoku Medical and Pharmaceutical University, Sendai 981-8536, Japan
| | - Senri Shinohara
- Division of Otolaryngology, Tohoku Medical and Pharmaceutical University, Sendai 981-8536, Japan
| | - Kazuhiro Murakami
- Division of Pathology, Tohoku Medical and Pharmaceutical University, Sendai 981-8536, Japan
| | - Miho Nakazumi
- Division of Otolaryngology, Tohoku Medical and Pharmaceutical University, Sendai 981-8536, Japan
| | - Takahiro Suzuki
- Division of Otolaryngology, Tohoku Medical and Pharmaceutical University, Sendai 981-8536, Japan
| | - Teruyuki Sato
- Division of Otolaryngology, Tohoku Medical and Pharmaceutical University, Sendai 981-8536, Japan
| | - Kazue Ise
- Division of Pathology, Tohoku Medical and Pharmaceutical University, Sendai 981-8536, Japan.,Technical Services Division, Tohoku Medical and Pharmaceutical University, Sendai 981-8536, Japan
| | - Yuriko Kagaya
- Division of Radiology, Tohoku Medical and Pharmaceutical University, Sendai 981-8536, Japan
| | - Ryo Tamura
- Division of Radiology, Tohoku Medical and Pharmaceutical University, Sendai 981-8536, Japan
| | - Keigo Murakami
- Division of Pathology, Tohoku Medical and Pharmaceutical University, Sendai 981-8536, Japan
| | - Yasuhiro Nakamura
- Division of Pathology, Tohoku Medical and Pharmaceutical University, Sendai 981-8536, Japan
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Sommer F. Rare Diseases of the Nose, the Paranasal Sinuses, and the Anterior Skull Base. Laryngorhinootologie 2021; 100:S1-S44. [PMID: 34352902 PMCID: PMC8354577 DOI: 10.1055/a-1331-2469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Due to their low incidence and thus resulting limited diagnostic criteria as well as therapeutic options, rare diseases of the nose, the paranasal sinuses, and the anterior skull base are a significant challenge. The value as of which a disease has to be considered as rare amounts to a maximum of 5 patients per 10 000 people. Within these diseases, however, there are extreme differences. Some rare or orphan diseases like for example the inverted papilloma belong to regularly diagnosed and treated diseases of larger departments of oto-rhino-laryngology whereas other rare diseases and malformations have only been described in less than 100 case reports worldwide. This fact emphasizes the necessity of bundling the available experience of diagnostics and therapy. The present article gives an overview about rare diseases of the nose, the paranasal sinuses, and the anterior skull base from the field of diseases/syndromes of the olfactory system, malformations of the nose and paranasal sinuses, ventilation and functional disorders as well as benign and malignant tumors. The classification and data on diagnostic and therapeutic options were established based on the current literature.
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Affiliation(s)
- Fabian Sommer
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Hals-Chirurgie, Universitätsklinik Ulm
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“Hey! Whatever happened to hemangiopericytoma and fibrosarcoma?” An update on selected conceptual advances in soft tissue pathology which have occurred over the past 50 years. Hum Pathol 2020; 95:113-136. [DOI: 10.1016/j.humpath.2019.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/09/2019] [Indexed: 12/29/2022]
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Biphenotypic sinonasal sarcoma: demographics, clinicopathological characteristics, molecular features, and prognosis of a recently described entity. Virchows Arch 2018; 473:615-626. [PMID: 30109475 DOI: 10.1007/s00428-018-2426-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 07/23/2018] [Accepted: 07/24/2018] [Indexed: 01/23/2023]
Abstract
Biphenotypic sinonasal sarcoma (BSNS) is a recently recognized type of sarcoma arising exclusively in the sinonasal tract displaying unique clinical course, histopathology, and genetics. Due to its rarity, only case series and case reports are available. In order to provide an overview of the current understanding of this disease, we present a comprehensive review of the literature and present three previously unreported cases of BSNS. A total of 55 genetically characterized and 41 cases without molecular data were identified in the literature. Two-thirds of patients were female and the peak incidence was in the fifth decade. Fatal outcome was rare (two cases with intracranial extension) and local recurrence occurred in 31.6%, all occurring within 5 years after initial treatment. Histologically, BSNS is highly cellular in the majority of cases and composed of fascicles of spindle cells, with entrapped hyperplastic surface epithelium being a frequent finding. The immunohistochemical profile is characteristic due to the biphasic nature of this lesion, with shared features of both myogenic and neural origin. Rhabdomyoblastic differentiation is apparent in a subset of cases. The most common genetic event is the PAX3-MAML3 fusion (58.6%) but isolated PAX3 rearrangement (19.2%), absence of rearrangements (9.1%), PAX3-FOXO1 (8.1%), PAX3-NCOA1 (4%), and isolated MAML3 rearrangement (2%) have also been reported. In conclusion, the recognition of BSNS is crucial due to its relatively indolent clinical course. A selected immunohistochemical panel and/or molecular confirmation can be used to aid in appropriate diagnosis and consequently in prognostication and to avoid overtreatment with chemotherapy regimens used in its mimics.
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