Синоназальные опухоли: клинико-морфологические особенности и дифференциальная диагностика

В рутинной практике врача-патологоанатома злокачественные синоназальные опухоли наблюдаются нечасто (1% всех новообразований). Большая часть данных карцином представляет собой низко или недифференцированные опухоли. Проявляя себя пересекающимися признаками, данные опухоли часто приводят к диагностическим проблемам как у молодых врачей, так и у опытных коллег. В статье рассмотрены два клинических случая диагностики и лечения новообразований синоназального тракта, входящих в группу мелкоклеточно-голубоклеточных опухолей. Это синоназальная мелкоклеточная нейроэндокринная опухоль и эстезионейробластома. 

1. Bracigliano A, Tatangelo F, Perri F, et al. Malignant sinonasal tumors: update on histological and clinical management. Curr Oncol. 2021;28(4):2420–2438. PMID: 34287240. PMCID: PMC8293118. https://doi.org/10.3390/curroncol28040222

2. Trieu V, Aulet RM, Ciolino A, Rimash T. SMARCB1-deficient sinonasal carcinoma: a case report and discussion of the clinical implications. Ann Otol Rhinol Laryngol. 2019;128(7):676–680. PMID: 30873845. https://doi.org/10.1177/0003489419836668

3. Shaverdashvili K, Azimi-Nekoo E, Cohen P, et al. INI1 (SMARCB1)-deficient undifferentiated sinonasal carcinoma: novel paradigm of molecular testing in the diagnosis and management of sinonasal malignancies. Oncologist. 2020;25(9):738–744. PMID: 32337786. PMCID: PMC7485347. https://doi.org/10.1634/theoncologist.2019-0830

4. Parsel SM, Jawad BA, McCoul ED. SMARCB1-deficient sinonasal carcinoma: systematic review and case report. World Neurosurg. 2020;136:305–310. PMID: 32001406. https://doi.org/10.1016/j.wneu.2020.01.130

5. Bell D, Hanna EY, Agaimy A, Weissferdt A. Reappraisal of sinonasal undifferentiated carcinoma: SMARCB1 (INI1)-deficient sinonasal carcinoma: a single-institution experience. Virchows Arch. 2015;467(6):649–656. PMID: 26407663. https://doi.org/10.1007/s00428-015-1853-1

6. McHugh KE, Policarpio-Nicolas MLC. Metastatic SMARCB1 (INI-1)-deficient sinonasal carcinoma diagnosed by endobronchial ultrasound-guided fine-needle aspiration (EBUSFNA): a potential diagnostic pitfall and review of the literature. Acta Cytol. 2019;63(5):431–437. PMID: 31132763. https://doi.org/10.1159/000500351

7. Simons SA, Bridge JA, Leon ME. Sinonasal small round blue cell tumors: an approach to diagnosis. Semin Diagn Pathol. 2016;33(2):91–103. PMID: 26585346. https://doi.org/10.1053/j.semdp.2015.09.010

8. Thompson LD. Small round blue cell tumors of the sinonasal tract: a differential diagnosis approach. Mod Pathol. 2017;30(s1):S1–S26. PMID: 28060373. https://doi.org/10.1038/modpathol.2016.119

9. Bell D. Sinonasal neuroendocrine neoplasms: current challenges and advances in diagnosis and treatment, with a focus on olfactory neuroblastoma. Head Neck Pathol. 2018;12(1):22–30. PMID: 29427030. PMCID: PMC5873495. https://doi.org/10.1007/s12105-018-0887-5

10. WHO Classification of Tumours Editorial Board, ed. Head and Neck Tumours. 5th ed. World Health Organization; 2024. WHO Classification of Tumours; vol 9.

11. Su SY, Bell D, Hanna EY. Esthesioneuroblastoma, neuroendocrine carcinoma, and sinonasal undifferentiated carcinoma: differentiation in diagnosis and treatment. Int Arch Otorhinolaryngol. 2014;18(Suppl 2):S149–S156. PMID: 25992139. PMCID: PMC4399581. https://doi.org/10.1055/s-0034-1390014

12. Han G, Wang Z, Guo X, Wang M, Wu H, Liu D. Extrapulmonary small cell neuroendocrine carcinoma of the paranasal sinuses: a case report and review of the literature. J Oral Maxillofac Surg. 2012;70(10):2347–2351. PMID: 22330330. https://doi.org/10.1016/j.joms.2011.10.034

13. Raychowdhuri RN. Oat-cell carcinoma and paranasal sinuses. J Laryngol Otol. 1965;79:253–255. PMID: 14270662. https://doi.org/10.1017/s0022215100063660

14. Mills SE. Neuroectodermal neoplasms of the head and neck with emphasis on neuroendocrine carcinomas. Mod Pathol. 2002;15(3):264–278. PMID: 11904342. https://doi.org/10.1038/modpathol.3880522

15. Mittal R, Kaza H, Agarwal S, Rath S, Gowrishankar S. Small cell neuroendocrine carcinoma of the orbit presenting as an orbital abscess in a young female. Saudi J Ophthalmol. 2019;33(3):308–311. PMID: 31686977. PMCID: PMC6819753. https://doi.org/10.1016/j.sjopt.2018.07.003

16. Rivero A, Liang J. Sinonasal small cell neuroendocrine carcinoma: a systematic review of 80 patients. Int Forum Allergy Rhinol. 2016;6(7):744–751. PMID: 26880574. https://doi.org/10.1002/alr.21734

17. Bishop JA, Guo TW, Smith DF, et al. Human papillomavirus-related carcinomas of the sinonasal tract. Am J Surg Pathol. 2013;37(2):185–192. PMID: 23095507. PMCID: PMC3545097. https://doi.org/10.1097/PAS.0b013e3182698673

18. Laco J, Sieglová K, Vošmiková H, et al. The presence of high-risk human papillomavirus (HPV) E6/E7 mRNA transcripts in a subset of sinonasal carcinomas is evidence of involvement of HPV in its etiopathogenesis. Virchows Arch. 2015;467(4):405–415. PMID: 26229021. https://doi.org/10.1007/s00428-015-1812-x

19. Wang CP, Hsieh CY, Chang YL, et al. Postirradiated neuroendocrine carcinoma of the sinonasal tract. Laryngoscope. 2008;118(5):804–809. PMID: 18520182. https://doi.org/10.1097/MLG.0b013e3181671491

20. Chapurin N, Totten DJ, Louis PC, et al. Sinonasal small cell carcinoma-case series of a rare malignancy. Ear Nose Throat J. 2022;101(6):392–395. PMID: 33090899. https://doi.org/10.1177/0145561320964640

21. Babin E, Rouleau V, Vedrine PO, et al. Small cell neuroendocrine carcinoma of the nasal cavity and paranasal sinuses. J Laryngol Otol. 2006;120(4):289–297. PMID: 16526967. https://doi.org/10.1017/S0022215106000594

22. Dearnaley D. Small-cell lung cancer: report of a meeting of physicians and scientists at the Royal Marsden Hospital. Lancet. 1995;345:1285–1289.

23. Ibrahim NB, Briggs JC, Corbishley CM. Extrapulmonary oat cell carcinoma. Cancer. 1984;54(8):1645–1661. PMID: 6089995.

24. Iezzoni JC, Mills SE. “Undifferentiated” small round cell tumors of the sinonasal tract: differential diagnosis update. Am J Clin Pathol. 2005;124 Suppl:S110–S121. PMID: 16468421. https://doi.org/10.1309/59RBT2RK6LQE4YHB

25. Дзагахова А.В., Катамадзе Н.Н., Пигарова Е.А. Синдром неадекватной секреции антидиуретического гормона в практике эндокринолога. Эндокринная хирургия. 2020;14(3):4–12. https://doi.org/10.14341/serg12692

26. Thompson LDR. Olfactory neuroblastoma. In: Thompson LDR, Müller S, Nelson BL. Diagnostic Pathology: Head and Neck. 3rd ed. Elsevier; 2022:154–164.

27. Broich G, Pagliari A, Ottaviani F. Esthesioneuroblastoma: a general review of the cases published since the discovery of the tumour in 1924. Anticancer Res. 1997;17(4A):2683–2706. PMID: 9252701.

28. Klepin HD, McMullen KP, Lesser GJ. Esthesioneuroblastoma. Curr Treat Options Oncol. 2005;6(6):509–518. PMID: 16242055. https://doi.org/10.1007/s11864-005-0029-7

29. Kumar R. Esthesioneuroblastoma: multimodal management and review of literature. World J Clin Cases. 2015;3(9):774– 778. PMID: 26380824. PMCID: PMC4568526. https://doi.org/10.12998/wjcc.v3.i9.774

30. Gray ST, Holbrook EH, Najm MH, Sadow PM, Curry WT, Lin DT. Syndrome of inappropriate antidiuretic hormone secretion in patients with olfactory neuroblastoma. Otolaryngol Head Neck Surg. 2012;147(1):147–151. PMID: 22368044. https://doi.org/10.1177/0194599812438842

31. Holland H, Koschny R, Krupp W, et al. Comprehensive cytogenetic characterization of an esthesioneuroblastoma. Cancer Genet Cytogenet. 2007;173(2):89–96. PMID: 17321323. https://doi.org/10.1016/j.cancergencyto.2006.09.024

32. Bockmühl U, You X, Pacyna-Gengelbach M, Arps H, Draf W, Petersen I. CGH pattern of esthesioneuroblastoma and their metastases. Brain Pathol. 2004;14(2):158–163. PMID: 15193028. PMCID: PMC8095953. https://doi.org/10.1111/j.1750-3639.2004.tb00048.x

33. Nair SS, Elizabeth MI. Esthesioneuroblastoma. Indian J Otolaryngol Head Neck Surg. 1998;50(1):33–35. PMID: 23119374. PMCID: PMC3451258. https://doi.org/10.1007/BF02996765

34. Горбунова Т.В., Родина А.Д., Шишков Р.В. и др. Подходы к лечению детей с эстезионейробластомой: обзор литературы. Онкопедиатрия. 2019;6(2):78–86. https://doi.org/10.15690/onco.v6i2.2019

35. Мустафаев Д.М., Свистушкин В.М., Самбулов В.И. и др. Эстезионейробластома полости носа (ольфакторная нейробластома). Российская оториноларингология. 2009;(5):85–91.

36. Пачес А.И. Опухоли головы и шеи. Медицина; 1983.

37. Ghaffar S, Salahuddin I. Olfactory neuroblastoma: a case report and review of the literature. Ear Nose Throat J. 2005;84(3):150– 152. PMID: 15871582.

38. Kumar R, Ghoshal S, Khosla D, et al. Survival and failure outcomes in locally advanced esthesioneuroblastoma: a single centre experience of 15 patients. Eur Arch Otorhinolaryngol. 2013;270(6):1897–1901. PMID: 23179939. https://doi.org/10.1007/s00405-012-2280-4