Carcinoma Ex-Schneiderian Papilloma (Malignant Transformation): A Clinicopathologic and Immunophenotypic Study of 20 Cases Combined with a Comprehensive Review of the Literature

摘要: Schneiderian papilloma (SP) are uncommon tumors with malignant transformation even less common. The histologic criteria to define not well developed nor is the immunohistochemical profile reported in a large series of carcinomas. 20 cases SP included 7 females and 13 males, aged 38–86 years (mean 60.7 years). Patients presented most frequently mass (n = 11) obstructive symptoms (n = 7), present for 38.7 months (mean). Most patients had no previous history (n = 13); metachronous carcinoma was identified an average 34.4 months after first diagnosis SP, 1–4 recurrences SP. With mean size 4.1 cm, majority involved combination more than one anatomic site (n = 10), followed by maxillary sinus only (n = 5) or nasal cavity (n = 3). Histologically, 17 were inverted 3 exophytic type There squamous cell carcinomas, 2 mucoepidermoid carcinomas 1 sinonasal undifferentiated carcinoma, comprising from 10 95 % tumor volume. Malignant features atypical mitoses, necrosis, bone invasion, lymphovascular decreased transmigrating neutrophils, paradoxical maturation, dyskeratosis and/or perineural invasion tended advanced stage (n = 14, Stage III IV). Immunohistochemical studies showed positive reactions malignancies CK5/6 (86 %), p63 CK7 (luminal, 50 %), p53 (83 %), p16 (25 %). In situ hybridization detected human papillomavirus 26 %. Surgery often accompanied radiation therapy (n = 13), 2.4 years follow-up. Five recurrence between 0.8 3.3 years. Carcinomas ex-SP common associated better outcome previously reported. tend synchronous developing malignancy. Development always preceded this series.