Verrucous carcinoma of the maxillary antrum

Epidemiology and survival outcomes of sinonasal verrucous carcinoma in the United States

INTRODUCTION

Verrucous carcinoma (VC) is a rare, variant of squamous cell carcinoma with benign cytohistopathologic features and a generally favorable prognosis. Epidemiologic and clinical outcomes data are lacking as a result of limited cases of sinonasal VC.

OBJECTIVE

To describe the incidence and determinants of survival of patients with verrucous carcinoma of the sinonasal tract between the years of 1973 to 2014 using the Surveillance, Epidemiology, and End Results (SEER) database.

METHODS

The SEER registry was utilized to calculate survival trends for patients with verrucous carcinoma of the sinonasal tract between 1973 and 2014. Patient data then was analyzed with respect to age, sex, race, and treatment modalities (surgery and radiation therapy). Overall survival (OS) and disease-specific survival (DSS) were calculated.

RESULTS

A total of 86 cases of VC of the sinonasal tract were identified. The cohort was comprised of 69.8% males. The mean age at diagnosis was 67.4 years. The nasal cavity was the most common primary site (51.2%), followed by the maxillary sinus (40.7%) and nasopharynx (5.8%). The median OS was 97.6 months. 89.5% of cases underwent surgery and 20.9% received both surgery and radiation therapy. Overall survival at 2, 5, and 10 years was 73%, 59%, and 36%, respectively. On multivariate analysis, advanced age (P < 0.05) and primary site (P < 0.05) were associated with worse OS and DSS, respectively. Primary nasopharyngeal tumor site was associated with reduced DSS (P < 0.05). Surgery improved OS (P < 0.001) and DSS (P < 0.001).

CONCLUSION

Verrucous carcinoma of the sinonasal tract is associated with a generally favorable prognosis. Age, primary site, and surgical therapy are independent predictors of OS and DSS, respectively. We present the first population-based analysis of sinonasal VC, thus clarifying the prognosis and reinforcing the management of this malignancy.

LEVEL OF EVIDENCE

4. Laryngoscope, 128:651-656, 2017.

Verrucous carcinoma of the tongue — a rare case study

Verrucous carcinoma is a slow growing, well demarcated, exophytic variant of squamosus cell carcinoma with a characteristic verrucous presentation. It is a rare tumour and in 75% of cases it is localised in the oral cavity, and sporadically within the tongue. HPV infection is identified in 40% of patients. Good prognosis is characteristic for this tumour, since the 5-year survival is 93%. The authors describe a case of verrucous carcinoma localised in the tongue of a 62-year old patient. The clinical course, diagnostics and proposed treatment was described and discussed with the existing literature data.

Association of verrucous carcinoma and inverted papilloma in the sinonasal tract

It is well known that inverted papilloma (IP) is sometimes associated with malignancies; however, the association of IP with verrucous carcinoma (VC) is extremely rare. We herein report a case of IP in the nasal cavity with VC in the maxillary sinus. A 73-year-old Japanese woman presented with a 3-month history of right-sided nasal obstruction and repetitive epistaxis. A biopsy of the mass was performed and the pathological result proved to be IP. Computed tomography and magnetic resonance imaging revealed a moderately enhanced soft-tissue lesion filling the right nasal cavity and a ring-enhanced expansive lesion in the maxillary sinus. Under a tentative diagnosis of IP of the nasal cavity with maxillary empyema, she underwent right medial maxillectomy via a lateral rhinotomy approach, and a histopathological diagnosis of IP in the nasal cavity with VC in the maxillary sinus was obtained. Her postoperative clinical course was uneventful. She is currently free from symptoms, and there is no evidence of recurrence 5 months after surgery. The pathology, clinical manifestation, and treatment of VC associated with IP are reviewed from literature.

Verrucous carcinoma of the temporal bone and maxillary antrum: two unusual presentations of a rare tumor

BACKGROUND

Verrucous carcinoma (VC) is a low-grade variant of squamous cell carcinoma. The involvement of the temporal bone and maxillary antrum is very rare.

PATIENTS AND METHODS

The clinicopathologic features of 2 such tumors are reported, and the pertinent literature is reviewed.

RESULTS

In the 2 patients, the diagnostic procedure was complicated due to initial inconclusive histology. Both were treated with concomitant radiochemotherapy. They were free of disease for 5.8 and 11 years after diagnosis. An additional 15 cases of VC of the temporal bone and 10 cases of maxillary antrum tumors have been reported in the literature. In 10 patients, multiple biopsies were required, and in 7 patients, a definitive histological diagnosis was not obtained before surgery. The disease reappeared in 8 out of 15 patients treated solely with surgery. Only 2 of them were salvaged by reoperation. Radiochemotherapy only (without any surgery) was successfully used in 4 patients.

CONCLUSIONS

VC of the temporal bone or maxillary antrum is an extremely rare tumor. For reliable histological diagnosis, multiple biopsies of deep and ample tissue samples are mandatory. Surgery is a mainstay of therapy; however, radiochemotherapy also represents a viable treatment option with curative potential.

Verrucous carcinoma of the paranasal sinuses: case report and clinical update

BACKGROUND

Verrucous carcinoma is a low-grade malignancy that has been reported to occur in all anatomic sites of the head and neck. Fourteen cases of verrucous carcinoma of paranasal sinus origin have been reported to date in the English literature.

METHODS

Case report and retrospective review of all cases of verrucous carcinoma of the paranasal sinuses in the English literature. All authors were contacted to provide missing data and long-term follow-up.

RESULTS

Five of the eight authors contacted responded, and the most current data from all 15 cases was compiled. Eleven of the 15 patients (73%) were men and ranged in age from 35 to 81 years (median, 68 years). The maxillary sinus is the most common paranasal sinus involved (93%). Presentation often occurred late, with 12 of 15 (80%) initially being seen at stage T3 or higher. Surgical excision was the treatment of choice, and median disease-free survival was 54 months.

CONCLUSIONS

Verrucous carcinoma of the paranasal sinuses is a rare but potentially curable disease. Treatment is surgical, and prognosis is good with early intervention.

Verrucous carcinoma of the maxillary antrum

Verrucous carcinoma is a well-differentiated variant of squumous cell carcinoma. In this article, we present a patient of verrucous carcinoma of the maxillary annum. There are only 6 reported cases of verrucous carcinoma of the maxillary antrum. Ours is the 7th case. We, here, would like to highlight that our case had a different clinical presentation from the previously reported cases.

Factors in the pathogenesis of tumors of the sphenoid and maxillary sinuses: a comparative study

OBJECTIVES/HYPOTHESIS

To explain the processes that lead to the development of tumors in the maxillary and sphenoid sinuses.

STUDY DESIGN

A 32-year review of the world's literature on neoplasms of these two sinuses and a randomized case-controlled study comparing the normal mucosal architecture of the maxillary to the sphenoid sinus.

METHODS

Analysis of a 32-year world literature review reporting series of cases of maxillary and sphenoid sinus tumors. Tumors were classified by histological type and separated into subgroups if an individual incidence rate was reported. Histomorphometry of normal maxillary and sphenoid sinus mucosa was performed in 14 randomly selected patients (10 sphenoid and 4 maxillary specimens). Specimens were fixed in 10% formalin, embedded in paraffin, and stained with periodic acid-Schiff (PAS) and hematoxylin. Histomorphometric analysis was performed with a Zeiss Axioscope light microscope (Carl Zeiss Inc., Thornwood, NY) mounted with a Hamamatsu (Hamamatsu Photonics, Tokyo, Japan) color-chilled 3 charge coupled device digital camera. The images were captured on a 17-inch Sony (Sony Corp., Tokyo, Japan) multiscan monitor and analyzed with a Samba 4000 Image Analysis Program (Samba Corp., Los Angeles, CA). Five random areas were selected from strips of epithelium removed from each sinus, and goblet and basal cell measurements were made at magnifications x 100 and x 400.

RESULTS

The literature review revealed that the number and variety of tumors in the maxillary sinus are much greater than those in the sphenoid. The incidence of metastatic lesions to each sinus is approximately equal. No recognized pattern of spread from any particular organ system could be determined. On histomorphometric study there were no statistically significant differences between the sinuses in the concentration of goblet cells, basal cells, or seromucinous glands.

CONCLUSIONS

Factors involved in the pathogenesis of tumors of the maxillary and sphenoid sinuses include differences in nasal physiology, embryology, morphology, and topography. There are no significant histological differences in the epithelium and submucous glands between the two sinuses to explain the dissimilar formation of neoplasms.