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Ali EH, Mengesha MW. Sinonasal adenocarcinoma presented as a giant anterior cranial fossa mass: a case report and review of the literature. J Med Case Rep 2024; 18:85. [PMID: 38433203 PMCID: PMC10910768 DOI: 10.1186/s13256-024-04413-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 01/25/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Intestinal adenocarcinoma accounts for less than 0.1-4% of all malignancies in the region. It is common among woodworkers and leather workers. Sinonasal adenocarcinoma usually arises from the ethmoid sinus (40%) or nasal cavity (25%). Extension to nearby structures is common, but intracranial spread is very rare. These tumors are usually treated with surgery, with a reported 5-year survival rate of 59% to 80%. CASE PRESENTATION This is a 60-year-old Black African male patient who presented with globalized headache, nasal obstruction with snoring during sleep, anosmia, change in mentation, sometimes agitation and left-side visual loss of one-year duration with worsening his above symptoms over the last one month. He couldn't smell soap bilaterally; in his left eye he could see only hand movement at nearly 30 cm. On brain magnetic resonance imaging, there was a T1 hypo- and T2 hyper-intense anterior cranial fossa mass arising from the left ethmoid sinuses and sphenoid sinuses and compressing the left optic structures, and brain computed tomography demonstrated heterogeneous hypo- to isodense mass. Complete tumor excision achieved and discharged with significant improvement and linked to oncology unit for radiotherapy. CONCLUSION The management of these patients is multidisciplinary, involving neurosurgeons, otolaryngologists, oncologists, and maxillofacial surgeons. Surgical resection is the main treatment strategy, followed by radiotherapy, particularly intensity-modulated therapy. Chemotherapy is used in highly advanced, metastatic, and unresectable tumors.
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Affiliation(s)
- Endris Hussen Ali
- Department of Neurosurgery, St. Paul's Millennium Medical College, Addis Ababa, Ethiopia.
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Akay S, Pollard JH, Saad Eddin A, Alatoum A, Kandemirli S, Gholamrezanezhad A, Menda Y, Graham MM, Shariftabrizi A. PET/CT Imaging in Treatment Planning and Surveillance of Sinonasal Neoplasms. Cancers (Basel) 2023; 15:3759. [PMID: 37568575 PMCID: PMC10417627 DOI: 10.3390/cancers15153759] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
Sinonasal cancers are uncommon malignancies with a generally unfavorable prognosis, often presenting at an advanced stage. Their high rate of recurrence supports close imaging surveillance and the utilization of functional imaging techniques. Whole-body 18F-FDG PET/CT has very high sensitivity for the diagnosis of sinonasal malignancies and can also be used as a "metabolic biopsy" in the characterization of some of the more common subgroups of these tumors, though due to overlap in uptake, histological confirmation is still needed. For certain tumor types, radiotracers, such as 11C-choline, and radiolabeled somatostatin analogs, including 68Ga-DOTATATE/DOTATOC, have proven useful in treatment planning and surveillance. Although serial scans for posttreatment surveillance allow the detection of subclinical lesions, the optimal schedule and efficacy in terms of survival are yet to be determined. Pitfalls of 18F-FDG, such as post-surgical and post-radiotherapy crusting and inflammation, may cause false-positive hypermetabolism in the absence of relapse.
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Affiliation(s)
- Sinan Akay
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Janet H. Pollard
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Assim Saad Eddin
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Aiah Alatoum
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Sedat Kandemirli
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA 90030, USA
| | - Yusuf Menda
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Michael M. Graham
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Ahmad Shariftabrizi
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
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Yokoyama K, Manabe O, Tsuchiya J, Oyama J, Kawabe H, Tateishi Y, Asakage T, Yamamoto K, Tateishi U. A rare case of cranial and spinal leptomeningeal dissemination of recurrent ethmoid carcinoma detected by [18F]-FDG PET/CT. Eur J Nucl Med Mol Imaging 2020; 48:1266-1267. [PMID: 32974735 DOI: 10.1007/s00259-020-05048-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/18/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Kota Yokoyama
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Osamu Manabe
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Department of Radiology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Jyunichi Tsuchiya
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Jun Oyama
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Hiroaki Kawabe
- Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yumiko Tateishi
- Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takahiro Asakage
- Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kouhei Yamamoto
- Department of Comprehensive Pathology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ukihide Tateishi
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
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Orlandi E, Iacovelli NA, Cavallo A, Resteghini C, Gandola L, Licitra L, Bossi P. Could the extreme conformality achieved with proton therapy in paranasal sinuses cancers accidentally results in a high rate of leptomeningeal progression? Head Neck 2019; 41:3733-3735. [PMID: 31313409 DOI: 10.1002/hed.25848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 06/14/2019] [Indexed: 11/10/2022] Open
Affiliation(s)
- Ester Orlandi
- Radiotherapy 2 Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Radiotherapy 1 Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Nicola A Iacovelli
- Radiotherapy 2 Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Anna Cavallo
- Medical Physics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Carlo Resteghini
- Head & Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lorenza Gandola
- Radiotherapy 1 Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lisa Licitra
- Head & Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Italy
| | - Paolo Bossi
- ASST Spedali Civili di Brescia, Medical Oncology Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, Brescia, Italy
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Chowdhary S, Damlo S, Chamberlain MC. Cerebrospinal Fluid Dissemination and Neoplastic Meningitis in Primary Brain Tumors. Cancer Control 2017; 24:S1-S16. [PMID: 28557973 DOI: 10.1177/107327481702400118] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Neoplastic meningitis, also known as leptomeningeal disease, affects the entire neuraxis. The clinical manifestations of the disease may affect the cranial nerves, cerebral hemispheres, or the spine. Because of the extent of disease involvement, treatment options and disease staging should involve all compartments of the cerebrospinal fluid (CSF) and subarachnoid space. Few studies of patients with primary brain tumors have specifically addressed treatment for the secondary complication of neoplastic meningitis. Therapy for neoplastic meningitis is palliative in nature and, rarely, may have a curative intent. METHODS A review of the medical literature pertinent to neoplastic meningitis in primary brain tumors was performed. The complication of neoplastic meningitis is described in detail for the various types of primary brain tumors. RESULTS Treatment of neoplastic meningitis is complicated because determining who should receive aggressive, central nervous system (CNS)-directed therapy is difficult. In general, the therapeutic response of neoplastic meningitis is a function of CSF cytology and, secondarily, of the clinical improvement in neurological manifestations related to the disease. CSF cytology may manifest a rostrocaudal disassociation; thus, consecutive, negative findings require that both lumbar and ventricular cytological testing are performed to confirm the complete response. Based on data from several prospective, randomized trials extrapolated to primary brain tumors, the median rate of survival for neoplastic meningitis is several months. Oftentimes, therapy directed at palliation may improve quality of life by protecting patients from experiencing continued neurological deterioration. CONCLUSIONS Neoplastic meningitis is a complicated disease in which response to therapy varies by histology. Thus, survival rates after CNS-directed therapy will differ by the underlying primary tumor. Optimal therapy of neoplastic meningitis is poorly defined, and few guidelines exist to guide clinicians on the most appropriate choice of therapy.
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Affiliation(s)
| | | | - Marc C Chamberlain
- Seattle Cancer Care Alliance, Cascadian Therapeutics, Seattle, Washington, USA.
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Martínez-Girón R, Mosquera-Martínez J, Martínez-Torre S. Leptomeningeal dissemination from an ethmoidal sinus adenocarcinoma in cerebrospinal fluid cytology. QJM 2015; 108:821-2. [PMID: 25614610 DOI: 10.1093/qjmed/hcv004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Indexed: 11/14/2022] Open
Affiliation(s)
- R Martínez-Girón
- From the CFGS Anatomic Pathology and Cytology, Institute of Piedras Blancas, 33450 Asturias, Spain,
| | - J Mosquera-Martínez
- Medical Oncology Departament, Complejo Hospitalario Universitario de A Coruña, As Xubias, 84, 15006, A Coruña, Spain and
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Maroldi R, Ravanelli M, Farina D, Facchetti L, Bertagna F, Lombardi D, Nicolai P. Post-treatment Evaluation of Paranasal Sinuses After Treatment of Sinonasal Neoplasms. Neuroimaging Clin N Am 2015; 25:667-85. [PMID: 26476385 DOI: 10.1016/j.nic.2015.07.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The aim of imaging in the follow-up of asymptomatic patients treated for sinonasal neoplasms is to detect submucosal relapsing lesions. The challenge is to discriminate recurrent tissue within the changes resulting from unpredictable healing of tissue after surgery and radiotherapy. Scar, inflammation, and recurrence can be better separated with a multisequence MR imaging approach. The choice of the field of view should take into account the risk of in-field intracranial recurrences, craniofacial bone metastases, and perineural spread. Fluorodeoxyglucose-PET has a role in assessing distant metastasis. Its usefulness in local and regional surveillance has yet to be established.
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Affiliation(s)
- Roberto Maroldi
- Department of Radiology, University of Brescia, Radiologia 2 - Spedali Civili, Piazzale Spedali Civili 1, Brescia I-25123, Italy.
| | - Marco Ravanelli
- Department of Radiology, University of Brescia, Radiologia 2 - Spedali Civili, Piazzale Spedali Civili 1, Brescia I-25123, Italy
| | - Davide Farina
- Department of Radiology, University of Brescia, Radiologia 2 - Spedali Civili, Piazzale Spedali Civili 1, Brescia I-25123, Italy
| | - Luca Facchetti
- Department of Radiology, University of Brescia, Radiologia 2 - Spedali Civili, Piazzale Spedali Civili 1, Brescia I-25123, Italy
| | - Francesco Bertagna
- Nuclear Medicine, University of Brescia, Piazzale Spedali Civili 1, Brescia I-25123, Italy
| | - Davide Lombardi
- Department of Otorhinolaryngology, University of Brescia, Piazzale Spedali Civili 1, Brescia I-25123, Italy
| | - Piero Nicolai
- Department of Otorhinolaryngology, University of Brescia, Piazzale Spedali Civili 1, Brescia I-25123, Italy
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