Tumors of the Nose and Paranasal Sinuses: Promoting Factors and Molecular Mechanisms—A Systematic Review

Abstract

Sinonasal neoplasms are uncommon diseases, characterized by heterogeneous biological behavior, which frequently results in challenges in differential diagnosis and treatment choice. The aim of this review was to examine the pathogenesis and molecular mechanisms underlying the regulation of tumor initiation and growth, in order to better define diagnostic and therapeutic strategies as well as the prognostic impact of these rare neoplasms. A systematic review according to Preferred Reporting Items for Systematic Review and Meta-Analysis criteria was conducted between September and November 2022. The authors considered the three main histological patterns of sinonasal tumors, namely Squamous Cell Carcinoma, Intestinal-Type Adenocarcinoma, and Olfactory Neuroblastoma. In total, 246 articles were eventually included in the analysis. The genetic and epigenetic changes underlying the oncogenic process were discussed, through a qualitative synthesis of the included studies. The identification of a comprehensive model of carcinogenesis for each sinonasal cancer subtype is needed, in order to pave the way toward tailored treatment approaches and improve survival for this rare and challenging group of cancers.

Progress and emerging strategies to preserve function in the treatment of sinonasal cancer

“…Nevertheless, targeted therapies can be based on the results of trials in patients with more common head and neck tumors that share the same genetic mutations. The existing genetic data on SNC offer a rationale for personalized therapies for a significant percentage of patients 49 . Recent studies on SNC suggest that immune checkpoint inhibitors may have a beneficial impact on anticancer therapy 72 …”

“…The pathogenesis of most sinonasal malignancies is currently poorly understood, mainly due to their rarity. Both abnormal cell proliferation and programmed cell death imbalance appear to drive the malignant transformation of precursor lesions 49 . Additionally, human papillomavirus (HPV) infection may contribute to tumorigenesis which may become viewed as a favorable prognostic factor concerning treatment response.…”

“…Both abnormal cell proliferation and programmed cell death imbalance appear to drive the malignant transformation of precursor lesions. 49 Additionally, human papillomavirus (HPV) infection may contribute to tumorigenesis which may become viewed as a favorable prognostic factor concerning treatment response. Nevertheless, in the era of precision medicine, some progress has been made regarding the knowledge of the pathogenic mechanisms behind these cancers and to the identification of molecular alterations that may improve diagnosis, prognosis and the stratification of treatment.…”

“…The existing genetic data on SNC offer a rationale for personalized therapies for a significant percentage of patients. 49 Recent studies on SNC suggest that immune checkpoint inhibitors may have a beneficial impact on anticancer therapy. 72 A multi-institutional international study of checkpoint inhibitors in over 400 sinonasal melanomas retrospectively analyzed 505 cases of sinonasal mucosal melanoma (SNMM) from 11 institutions across the United States, United Kingdom, Ireland, and continental Europe.…”

Benign Nasosinus Tumors: Epidemiological, Clinical, Morphological, Therapeutic, and Evolutionary Aspects at the Adolphe SICE General Hospital in Pointe-Noire (Congo-Brazzaville)

“…These include nasosinusal polyps, pleiomorphic adenomas and inverted papillomas [1]. In the literature, some cases of inverted papilloma associated with highly oncogenic human papillomaviruses (HPV16 and 18) have been reported in the context of malignant degeneration, as have exceptional cases of pleomorphic adenoma [2] [3]. Certain risk factors have also been reported, notably nasosinusal allergy and chronic sinusitis [1].…”