Sinonasal mucosal melanoma: An enigma

Objective@#To report two cases of mucosal melanoma of the sinonasal cavity from India and review the literature emphasizing current important clinical and biologic aspects of this tumor. @*Methods@#Design: Case Report Setting: Tertiary Public Referral Hospital Patients: Two @*Results@#Two patients presenting with progressive unilateral nasal obstruction over three to six months, respectively, were diagnosed to have sinonasal mucosal melanoma. The mass involved the nasal cavity and maxillary antrum in both patients. The first patient deferred radiotherapy for four months until pulmonary metastasis became evident, necessitating palliative chemotherapy; the second patient underwent surgical excision and radiotherapy. @*Conclusion@#In spite of aggressive therapy, the prognosis for people with mucosal melanoma is extremely poor. Surgery remains the mainstay of treatment, although adjuvant radiation therapy has recently had an increasing role in the treatment of mucosal melanoma. A clear understanding of the pathophysiology of this disease may yield more specific immunotherapy and chemotherapy techniques. A multicenter prospective study is required to objectively assess the optimal treatment regimen.

MR Imaging Findings of Sinonasal Neuroendocrine Carcinoma: Two Case Reports

Sinonasal neuroendocrine carcinoma is a rare disease, and reports focusing on the MR imaging findings of sinonasal neuroendocrine carcinoma are extremely rare. Threrefore we intend to report 2 cases of histologically confirmed neuroendocrine carcinoma. A 62-year-old man and a 74-year-old man are both presented with nasal bleeding. Computed tomography(CT) images of the 2 patients showed large, ill-defined masses in sinonasal cavities with adjacent bony destructions. MR images showed masses with isosignal intensity on T1-weighted images and mixed iso- and high signal intensity on T2-weighted images. Postcontrast MR images showed heterogenous enhancement of masses with necrosis. Adjacent bony destructions were also noted on MR images. In both cases, peritumoral cystic lesions or mucoceles with high signal intensity on T1-weighted images were noted in sphenoid sinus. Both of the CT and MR imaging findings of the 2 patients were nonspecific which are usually seen in malignant tumor. But further study is needed for the significance of the peritumoral cystic areas adjacent the tumors.

Myxoid Chondrosarcoma of the Sinonasal Cavity in a Child: a Case Report

Chondrosarcomas are malignant tumors of cartilage that rarely involve the sinonasal region, and myxoid chondrosarcoma is a rare histologic variant of chondrosarcoma that usually occurs in the soft tissue of extremities. Although several case reports and results of small series of chondrosarcomas in the sinonasal region in children are available, myxoid type chondrosarcoma is extremely rare. We recently experienced a case of low grade myxoid chondrosarcoma involving the sinonasal cavity in a 10-year-old boy, and here we report its radiologic-pathologic findings. In this case, chondroid calcification on CT and septal and marginal enhancement on MRI suggested a chondrosarcoma. Whole body PET-CT demonstrated no definite metastatic lesion and a low peak standardized uptake value primary tumor. However, no definite distinguishing imaging features were observed that distinguished low grade myxoid chondrosarcoma from conventional chondrosarcoma.

Radiation Therapy Results of the Non-Hodgkin's Lymphoma of the Sinonasal cavity / 대한치료방사선과학회지

From January 1970 through December 1984, 15 patients with sinonasal Non-Hodgkin's lymphoma combined to the head and neck were treated by external irradiation. 13 patients were stage IE and 2 were stage IIE by Ann Arbor Classification. However, when using TNM system, 7 were locally advanced T3, T4 lesions. All patients had follow up from 3.7 to 16 years with the median follow-up of 8.5 years. The overall actuarial 5-year survival rates were 25%, 28% for IE and 0% for IIE. Total tumor dose varied from 40 to 68 Gy. 100% complete response with a total tumor dose of more than 55 Gy and 73% complete response with less than 55 Gy. When the disease was staged using the TNM (AJC) system, the five-year disease free survival for T1 and T2 patients was 50% as compared with 14% for T3 and T4. Failure rate by stage was 33% (2/6) for T1 and T2, 86% (6/7) for T3 and T4, and 100% (2/2) for IIE. The results suggest that 1. Higher CR could be obtained with a total tumor dose of more than 55 Gy. 2. Use of TNM staging system is as important as Ann arbor in management of sinonasal NHL. 3. The addition of combination chemotherapy should be considered for T3, T4 and IIE the sinonasal Non-Hodgkin's lymphoma although the disease is limited to head and neck.