CT and MRI diagnosis of neuroendocrine carcinoma in paranasal sinuses / 中华放射学杂志

ABSTRACT

ObjectiveTo investigate the CT and MRI characteristic features of neuroendocrine carcinoma in paranasal sinuses.MethodsCT and MRI findings of 10 patients with proved neuroendocrine carcinoma by pathology were retrospectively reviewed. All patients underwent plain and enhanced MRI scanning,and 9 patients also underwent CT manning.ResultsThere were 5 males and 5 females with mean age of (48 ± 9 ) years old,ranging from 27 to 57 years.The treatment time after symptoms onset ranged from 1 to 4 months,with the median of 2 months.Clinical symptoms were headache and vision loss,hyposmia and yellow nasal discharge,and exophthalmos.The lesions were located in the ethmoidal sinus ( n =6 ),maxillary sinus ( n =2),and bilateral sphenoid sinus ( n =5 ).The lesions were symmetrical in the sphenoid sinus.Pathology type included typical carcinoid tumor ( n =1 ),atypical carcinoid ( n =1 ),and neuroendocrine carcinoma not otherwise specified ( n =8 ). Immunohistochemical staining showed that neurospecific enolase,synaptophysin,cytokeratin and P53 were all positive.On CT images,lesions showed isointensity (n =1 ),iso- to hypointense (n =4 ),and iso- to hyperintense (n =4 ) with hypointense or hyperintense spots.Bone changes included bony absorption and sclerosis ( n =1 ) with a clear margin in typical carcinoid tumor,and moth-eaten bone destruction in other 8 cases( n =8).The lesions were isointense on T1-weighted images,and isointense (n =4) or mixed iso- to hyperintense on T2-weighted images (n =6).Lesions showed mild to medium heterogeneous enhancement ( n =7 ) or marked enhancement ( n =3 )on gadolinium-enhanced images.Time-signal intensity curve ( TIC ) showed plateau type in 2 cases.The aggressive nature of the tumors was demonstrated by invasion of adjacent structures,involvement of nasal cavity( n =9 ),orbits ( n =7 ),pterygopalatine fossa ( n =4 ),ethmoidalsinus and sphenoid ( n =3 ),clivus ossis occipitalis(n =2),cavernous sinus and internal carotid canal(n =2),optic canal(n =2),jugular fossa ( n =1 ),anterior fossa ( n =1 ),apex partis petrosae ossis temporalis ( n =1 ),meninges ( n =1 ),temporal fossa and infratemporal fossa ( n =1 ),pharyngonasal cavity and parapharyngeal space ( n =1 ).ConclusionsThere are different CT features in different pathological types of neuroendocrine carcinoma of the paranasal sinuses,and MRI can demonstrate the invasive extent accurately. CT combined MRI can provide more comprehensive information in the diagnosis and therapy.