HPV‐Related Multiphenotypic Sinonasal Carcinoma: A Case Report and Literature Review

Abstract

Objectives Human papilloma virus‐related multi phenotypic sinonasal carcinoma (HMSC), a recently characterized sinonasal malignancy, is discussed including histology, clinical presentation, and treatment outcomes. Study Design Case report with literature review. Methods A case of HMSC is reported, as well as a retrospective review of all cases of HMSC reported in the English literature from January 2000 through May 2018 in the MEDLINE, EMBASE, and Scopus databases. Case data from selected articles was pooled along with the presented case and analyzed. Results Including the present case report, a total of 57 cases of HMSC were identified through literature review. Of the 42 cases with staging information, 25 (60%) presented as early‐stage disease (T1/T2). No nodal metastasis or disease‐specific mortalities were reported. Among the 44 cases with posttreatment follow‐up data, 16 cases (36.4%) developed local recurrence. The majority of recurrences occurred 24 to 60 months posttreatment, although reports of recurrence 10 and 29 years posttreatment exist. Local recurrence occurred in 40% and 60% of patients with perineural invasion and bone invasion, respectively. Patients who developed local recurrence had a longer disease‐free interval when treated with adjuvant radiotherapy, which approached statistical significance. Conclusions HMSC is a distinct entity with paradoxically aggressive morphology paired with an indolent clinical course characterized by high rates of local recurrence but no reported disease‐specific mortalities to date. Surgery with or without adjuvant radiotherapy is the most common treatment modality, and adjuvant radiotherapy may be associated with an increased disease‐free interval among patients with local recurrence. Level of Evidence 4 Laryngoscope, 131:106–110, 2021

Human Papillomavirus-Related Multiphenotypic Sinonasal Carcinoma—An Even Broader Tumor Entity?

“…This is, to our knowledge, the first systematic review of HMSC in which all patients diagnosed with HMSC since the first report in 2013 were included and wherein we have attempted to summarize all available clinical and morphological data published so far. Taken together, the overall picture of the nature of the potentially new tumor entity HMSC has slightly changed since the initial summary reports [ 2 , 12 , 19 , 23 ], but is still mainly characterized by its indolent course despite an aggressive histomorphology.…”

Effectiveness of radiation therapy on brain invasion by human papillomavirus‐related multiphenotypic sinonasal carcinoma: A case report

“…Our patient had a poor prognosis; otherwise, all other reported cases had good clinical outcomes. [2][3][4][5][6][7][8][9][10][11] One of the most significant differences between our case and the other 65 cases was the presence of brain invasion. There is a report of HPV-related sinonasal carcinoma with adenoid cystic-like features with intracranial invasion.…”

“…Only 65 cases have been reported to date. [2][3][4][5][6][7][8][9][10][11] The major primary symptom was nasal obstruction or stenosis (51%, 25/49). 2 In contrast, our case did not present with nasal symptoms, and ICH was the primary symptom.…”

High-risk human papillomavirus enhances the expression of COX-2 VEGF, EGFR, ProEx-C, and TERT proteins in human papillomavirus-related multiphenotypic sinonasal carcinoma through activation of PI3K/Akt, pRb, and TERT signalling pathways

“…Human papillomavirus-related multiphenotypic sinonasal carcinoma is a unique HPV-related tumour with many of the histologic characteristics of sinonasal adenoid cystic carcinomas but lacks MYB/MYBL1/NFIB translocation and has features of squamous differentiation but exhibits myoepithelial proliferation. Despite its aggressive appearance and delayed clinical course marked by high local recurrence rates, little is known about HMSC's clinical behaviour [32].…”