Remirez-Castellanos Ana Lilia, Piña-Sanchez Patricia, Mantilla-Morales Alejandra, Valenzuela-Gonzalez Wilfredo, Candanedo González Fernando
Radiology, Unidad Medico de Alta Especialidad (UMAE) Hospital de Oncologia, Centro Medico Nacional Siglo XXI. IMSS, Mexico, MEX.
Medical Research Unit in Oncological Diseases, Unidad Medico de Alta Especialidad (UMAE) Hospital de Oncologia Centro Medico Nacional Siglo XXI. IMSS, Mexico, MEX.
Cureus. 2023 Jun 14;15(6):e40413. doi: 10.7759/cureus.40413. eCollection 2023 Jun.
Human Papillomavirus-related multiphenotypic sinonasal carcinoma is a rare, and recently described neoplasm, defined by its association with high-risk Human Papillomavirus, which exclusively affects the sinonasal tract and simulates salivary gland tumors. Due to the infrequency of this neoplasm and the lack of knowledge of its pathological characteristics, it is susceptible to diagnostic error. We describe the clinical-radiological findings of a 54-year-old man with multiphenotypic sinonasal carcinoma related to Human Papillomavirus genotype 56. The diagnosis of multiphenotypic sinonasal carcinoma was suspected by light microscopy and was corroborated by immunohistochemistry and polymerase chain reaction (PCR) analysis. The patient was subsequently treated with 63.6 gray radiotherapies. He is currently alive after a follow-up of 20 months, with a recurrence of the disease. In conclusion, multiphenotypic sinonasal carcinoma is an unusual neoplasm, which is not well recognized and can be confused with adenoid cystic carcinoma. However, multiphenotypic sinonasal carcinoma should be included in the differential diagnosis as we encounter sinonasal tumors, which by histology present tubular, cribriform, and solid growth patterns, accompanied by dysplasia or carcinoma in situ in the superficial mucosa. In this case, it is necessary to perform immunohistochemistry for p16INK4A or PCR to confirm the presence of high-risk Human Papilloma Virus, which would confirm the diagnosis.
人乳头瘤病毒相关的多表型鼻窦癌是一种罕见的、最近才被描述的肿瘤，其定义为与高危型人乳头瘤病毒相关，该肿瘤仅累及鼻窦并类似涎腺肿瘤。由于这种肿瘤罕见且对其病理特征了解不足，故易出现诊断错误。我们描述了一名54岁男性与人乳头瘤病毒56型相关的多表型鼻窦癌的临床影像学表现。多表型鼻窦癌的诊断通过光学显微镜检查怀疑，并经免疫组织化学和聚合酶链反应（PCR）分析得到证实。该患者随后接受了63.6戈瑞的放射治疗。随访20个月后他目前仍存活，但疾病复发。总之，多表型鼻窦癌是一种不常见的肿瘤，尚未得到充分认识，可能会与腺样囊性癌混淆。然而，当我们遇到鼻窦肿瘤时，若其组织学表现为管状、筛状和实性生长模式，同时伴有浅表黏膜发育异常或原位癌，多表型鼻窦癌应纳入鉴别诊断。在这种情况下，有必要进行p16INK4A免疫组织化学检测或PCR以确认高危型人乳头瘤病毒的存在，从而确诊。
